THERESA ADAMCZYK DDS
NPI 1962882308
Dentist - General Practice in Oshkosh, WI

NPI Status: Active since June 01, 2015

Contact Information

550 CITY CTR
OSHKOSH, WI
ZIP 54901
Phone: (920) 731-7445
Fax: (920) 651-3485

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Dentist
General Practice
Accepts Insurance
PECOS Enrolled

About THERESA ADAMCZYK

This page provides the complete NPI Profile along with additional information for Theresa Adamczyk, a provider established in Oshkosh, Wisconsin with a medical specialization in Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1962882308 assigned on June 2015. The practitioner's primary taxonomy code is 1223G0001X with license number 1001079-15 (WI). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI: 1962882308
Provider Name: THERESA ADAMCZYK DDS
Gender: Female
Entity Type: Individual
Location Address: 550 CITY CTR OSHKOSH, WI 54901
Location Phone: (920) 731-7445
Location Fax: (920) 651-3485
Mailing Address: 5337 W GRANDE MARKET DR APPLETON, WI 54913
Mailing Phone: (920) 731-7445
Mailing Fax: (920) 651-3485
Is Sole Proprietor?: No
Enumeration Date: 06-01-2015
Last Update Date: 05-15-2024
Code Navigator

A dentist like Theresa Adamczyk is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Secondary Locations

5337 W Grande Market Dr
Appleton, WI 54913
(920) 731-7445
5471 W Waterford Ln
Appleton, WI 54913
(920) 731-7445
825 W Fulton St
Waupaca, WI 54981
(920) 731-7445

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Dentist General Practice
Taxonomy Code: 1223G0001X
Type: Dental Providers
License No.: 1001079-15
License State: WI
Taxonomy Description: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Delta Dental of Wisconsin, Inc.

Delta Dental Individual and Family High Plan - PPO
Delta Dental Individual and Family Low Plan - PPO
Delta Dental Individual and Family Low Plan Major - PPO
Delta Dental PPO Plus Premier Family Plan High Option - PPO
Delta Dental PPO Plus Premier Family Plan Low Option - PPO

Guardian

Guardian Basics for Families and Individuals - PPO
Guardian Essentials for Families and Individuals - PPO
Guardian Preventive Plus for Families and Individuals - PPO
Guardian Select for Families and Individuals - PPO

Humana

Humana Dental Smart Choice - PPO
Humana Dental Smart Choice - High - PPO
Humana Dental Smart Choice - Lite - PPO
Humana Dental Smart Choice - Low - PPO
Humana Dental Smart Choice Basic - PPO
Humana Dental Smart Choice- Lite - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Theresa Adamczyk is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 54901 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $82.92
Minimum New Patient Price $53.9
Maximum New Patient Price $163.24

Average New Patient Copayment $20.73
Minimum New Patient Copayment $13.47
Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $67.37
Minimum Established Patient Price $17.4
Maximum Established Patient Price $133.76

Average Established Patient Copayment $16.84
Minimum Established Patient Copayment $4.35
Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	9	6	2	8	8	2	3	0	8
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	9	12	2	16	8	4	3	0
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 2 + 2 + 1 + 6 + 8 + 4 + 3 + 0 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 8									8

The NPI number 1962882308 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.