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NICKY PLEMENTOSH M.D.
NPI 1467461053
Obstetrics & Gynecology in Milwaukee, WI

Active since August 05, 2006PECOS Enrolled
945 N 12TH ST, MILWAUKEE, WI 53233(414) 219-2000 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 1, 2021, Sep 13, 2021, Jun 19, 2018 and 1 more (4 updates tracked since 2016).

About Nicky Plementosh M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICKY PLEMENTOSH M.D. (NPI 1467461053) is an individual obstetrics & gynecology provider in Milwaukee, Wisconsin, licensed in Wisconsin (44280-020) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Green Bay.

NPPES Registry Identity

NPI1467461053
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameNICKY PLEMENTOSHCredential: M.D.
Location Address945 N 12TH STMilwaukee, WI 53233-1305
Mailing Address3301 W Forest Home AveMilwaukee, WI 53215-2843 · (414) 219-2000
Phone(414) 219-2000
Sole ProprietorNo
Enumeration DateAugust 5, 2006
Last NPPES UpdateDecember 1, 20214 updates tracked since enumeration
NPPES CertifiedDecember 1, 2021
✔ NPI 1467461053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in WI · 44280-020
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
945 N 12TH ST, Milwaukee, WI 53233
Open in Google Maps ↗

Secondary Practice Location 1

Location 11537 Park Pl Ste 200Green Bay, WI 54304-1974 · Phone (920) 498-8650 · Fax (920) 498-0945

Other Identifiers 1

Medicaid34186800WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, Dean Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicky Plementosh M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Nicky Plementosh reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Froedtert Manitowoc Medical Group, LLC
74 mi
Multi-Specialty
2300 WESTERN AVE
Manitowoc, WI 54220
  • Reassigned Medicare billing, Wisconsin enrollment
  • 350 clinicians in this Medicare group
NPI 1437829975 (920) 320-2436
Aspirus Wausau Hospital, Inc.
128 mi
Family Medicine
5409 VERN HOLMES DR
Stevens Point, WI 54482
  • Reassigned Medicare billing, Wisconsin enrollment
  • 633 clinicians in this Medicare group
NPI 1275886749 (715) 344-1600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53233 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD COMPTON KURTZ II MD
Family Medicine
945 N 12TH ST
MILWAUKEE, WI 53233
Milwaukee County (414) 219-0000
MS. ANN M YOCKEY APNP
Nurse Practitioner
945 N 12TH ST
MILWAUKEE, WI 53233
Milwaukee County (414) 219-5800
DR. ALINA M WINANS MD
Emergency Medicine
945 N 12TH ST
MILWAUKEE, WI 53233
Milwaukee County (414) 219-2000
MS. MORANDA MARIA MEDINA-LOPEZ RN
Registered Nurse
945 N 12TH ST
MILWAUKEE, WI 53233
Milwaukee County (414) 219-2000
XENAYSHMA ZHAYLEENE GNAS-PACHECO
Registered Nurse (Registered Nurse First Assistant)
945 N 12TH ST
MILWAUKEE, WI 53233
Milwaukee County (414) 000-0000
PROGRESSIVE COMMUNITY HEALTH CENTERS, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
945 N 12TH ST, URGENT CARE
MILWAUKEE, WI 53233
Milwaukee County (414) 935-8000
JOSEPH SHAOUL
Anesthesiologist Assistant
945 N 12TH ST
MILWAUKEE, WI 53233
Milwaukee County (414) 219-2000
MICHELE DUDA
Nurse Practitioner
945 N 12TH ST
MILWAUKEE, WI 53233
Milwaukee County (414) 219-7021

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicky Plementosh's NPI number?

The NPI number for Nicky Plementosh is 1467461053. It was assigned to this individual provider in the NPPES registry on August 5, 2006.

Where is Nicky Plementosh located?

Nicky Plementosh practices at 945 N 12th St, Milwaukee, WI 53233. The listed phone number is (414) 219-2000.

What is Nicky Plementosh's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Nicky Plementosh enrolled in Medicare?

Yes. Nicky Plementosh is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nicky Plementosh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicky Plementosh reassigns Medicare benefits to 2 organizations: Froedtert Manitowoc Medical Group, LLC (Manitowoc, WI) and Aspirus Wausau Hospital, Inc. (Stevens Point, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicky Plementosh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicky Plementosh accept?

Health plans from Aspirus Health Plan and Dean Health Plan list Nicky Plementosh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicky Plementosh was last updated on December 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.