Community Medical Center of Green Lake, LLC
NPI 1568622280 · Family Medicine Physician · Green Lake, WI
Community Medical Center of Green Lake, LLC is a Family Medicine Physician organization in Green Lake, WI (NPI 1568622280).
Provider details
- NPI number
- 1568622280
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Thomas Krystowiak, Chief Financial Officer(920) 361-1313
- License
- 44378 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Chn Medical Center Green Lake
Registry dates
- Enumerated
- 2008-06-16
- Last updated
- 2014-05-02
Frequently asked questions
- What is Community Medical Center of Green Lake, LLC's NPI number?
- Community Medical Center of Green Lake, LLC's National Provider Identifier (NPI) is 1568622280, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Community Medical Center of Green Lake, LLC?
- Community Medical Center of Green Lake, LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Community Medical Center of Green Lake, LLC located?
- Community Medical Center of Green Lake, LLC's practice location on file with NPPES is 670 County Road a, Green Lake, WI 54941.
- What is Community Medical Center of Green Lake, LLC's phone number?
- The practice phone number listed in the NPPES registry for Community Medical Center of Green Lake, LLC is (920) 294-0100.
- Who is the authorized official for Community Medical Center of Green Lake, LLC?
- The authorized official listed on Community Medical Center of Green Lake, LLC's NPPES record is Thomas Krystowiak, Chief Financial Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Community Medical Center of Green Lake, LLC's NPI active?
- Yes — Community Medical Center of Green Lake, LLC's NPI (1568622280) is active in the NPPES registry as of the last update on 2014-05-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.