Dominic Patrick Porubsky
Student in an Organized Health Care Education/Training Program in West Allis, WI. Individual provider (NPI-1).
Details
- NPI
- 1558093997
- Entity type
- Individual (NPI-1)
- Name
- Mr. Dominic Patrick Porubsky
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 24, 2022
- Certification date
- Jun 29, 2022
- Last updated
- Jun 29, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 104100000X | Social Worker | – | – | |
| 1041S0200X | Social Worker, School | – | – |
Practice location
2448 S 102nd St Ste 200West Allis, WI 53227-2141
Phone 414-327-3000
Mailing address
18700 Anita CtBrookfield, WI 53045-4229
Phone 262-765-1012
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 12 Student in an Organized Health Care Education/Training Program providers in West Allis · All 1,759 providers in West Allis
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