| Nicholas G Stephani, MD | |
|
5000 Memorial Dr, Two Rivers, WI 54241-3900 | |
| (920) 794-5000 | |
| Not Available |
| Full Name | Nicholas G Stephani |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 26 Years |
| Location | 5000 Memorial Dr, Two Rivers, 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 |
|---|---|---|---|
| 1114987203 | NPI | - | NPPES |
| 34551900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 47002 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| West Allis Memorial Hospital | West allis, WI | Hospital |
| Aurora Medical Center - Summit | Summit, WI | Hospital |
| Aurora Medical Center - Grafton | Grafton, WI | Hospital |
| Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
| Aurora Sheboygan Memorial Medical Ctr | Sheboygan, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Advanced Healthcare, Inc. | 3375625833 | 1012 |
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Lakeshore Medical Clinic Llc | 7719890730 | 325 |
| Amg Illinois Ltd | 8527117027 | 29 |
| 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 |
| Entity Name | Lakeshore Medical Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
| Entity Name | Aurora Advanced Healthcare, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
| Entity Name | Amg Illinois Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972741759 PECOS PAC ID: 8527117027 Enrollment ID: O20100129000033 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas G Stephani, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Nicholas G Stephani, MD 5000 Memorial Dr, Two Rivers, WI 54241-3900 Ph: (920) 794-5000 |