NPIMap

Organization Active NPI

Czarnecki Podiatry, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Mequon, WI
National Provider Identifier
1972716272
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
025-519 Issued in WI
Legal business name
CZARNECKI PODIATRY, INC.
Practice address
11203 N Buntrock Ave
Suite 103
Mequon, WI 53092-1857
Phone
(262) 242-0095
Fax
(262) 242-0884
NPI assigned
May 7, 2007
Last updated
Apr 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Thomas Nicholas Czarnecki Jr., D.P.M.NPI 1881769776
Title
Podiatrist
Phone
(262) 242-0095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 025-519 WI Primary

Addresses

Primary practice location

11203 N Buntrock Ave
Suite 103
Mequon, WI 53092-1857

Mailing address

11203 N Buntrock Ave
Suite 103
Mequon, WI 53092-1857
Phone (262) 242-0095

Other identifiers 1

IdentifierTypeStateIssuer
43268500MedicaidWI

National Provider Directory

National Provider Directory

Locations

11203 N Buntrock Ave
Ste 103
Mequon, WI 53092
Phone (262) 242-0095

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1972716272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11203 N BUNTROCK AVE",
            "address_2": "SUITE 103",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921857",
            "telephone_number": "262-242-0095",
            "fax_number": "262-242-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11203 N BUNTROCK AVE",
            "address_2": "SUITE 103",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921857",
            "telephone_number": "262-242-0095",
            "fax_number": "262-242-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CZARNECKI PODIATRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "CZARNECKI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "262-242-0095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "025-519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43268500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.