| John C Matteucci Jr, MD | |
|
6127 Green Bay Road, Suite 600, Kenosha, WI 53142-2973 | |
| (262) 653-9221 | |
| (262) 653-9229 |
| Full Name | John C Matteucci Jr |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 36 Years |
| Location | 6127 Green Bay Road, Kenosha, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558456749 | NPI | - | NPPES |
| 300037445 | Medicaid | IN | |
| 32467300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 01083818A (Indiana) | Secondary |
| 208800000X | Urology | 38866 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
| United Hospital System | Kenosha, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
| Entity Name | Ascension Medical Group-fox Valley Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730126392 PECOS PAC ID: 0244142420 Enrollment ID: O20031105000351 |
| Entity Name | Dean Health Systems Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053358846 PECOS PAC ID: 7012827983 Enrollment ID: O20031105000584 |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Mailing Address | Practice Location Address |
|---|---|
| John C Matteucci Jr, MD 6127 Green Bay Road, Suite 600, Kenosha, WI 53142-2973 Ph: (262) 653-9221 | John C Matteucci Jr, MD 6127 Green Bay Road, Suite 600, Kenosha, WI 53142-2973 Ph: (262) 653-9221 |
Dr. Meredith Carter Clubb, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 6308 8th Ave, Ste 503, Kenosha, WI 53143 Phone: 262-656-8213 Fax: 262-656-8233 | |
Dr. Harry M Matschke, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-5600 | |
Robert J Hartman Jr., M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-857-5880 | |
Ned R. Novsam, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 6308 8th Ave, Suite 503, Kenosha, WI 53143 Phone: 262-656-8213 Fax: 262-656-8233 |