Individual provider

Leonard Fagan, M.D.

Obstetrics & Gynecology Physician Specialist Medicare enrolled

Leonard Fagan, M.D. is an Obstetrics & Gynecology Physician in Kenosha, WI, registered under NPI 1104812171. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 10222 74TH STREET SUITE 200, Kenosha, WI 53142. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

10222 74TH STREET SUITE 200, Kenosha, WI 53142 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
ME157114 FL Obstetrics & Gynecology Physician primary
46372-020 WI Specialist
46372 WI Obstetrics & Gynecology Physician

Licences are recorded in 2 states: FL, WI. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Obstetrics/gynecology
PAC ID
1658356191

Medicare enrolment is recorded as approved under the provider type Practitioner - Obstetrics/gynecology. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Florida and Wisconsin. The practice address on file is in Kenosha, WI, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

FL Florida
Licence
ME157114
Specialty
Obstetrics & Gynecology Physician
Verify with the FL board →
WI Wisconsin practice address
Licence
46372-020
Specialty
Specialist
Verify with the WI board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Obstetrics & Gynecology covers

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. NUCC Health Care Provider Taxonomy, code 207V00000X
Allopathic & Osteopathic Physicians Obstetrics & Gynecology

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
207V00000X Obstetrics & Gynecology Physician ME157114 FL primary
174400000X Specialist 46372-020 WI
207V00000X Obstetrics & Gynecology Physician 46372 WI

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104812171 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateSep 23, 2005
Last updatedOct 3, 2022
StatusActive
Sole proprietorNo
CredentialM.D.
Practice address 10222 74TH STREET
SUITE 200
Kenosha, WI 53142
(262) 697-9200
Fax (262) 697-9206
Mailing address 3301 W FOREST HOME AVE
Milwaukee, WI 53215
Other identifiers 34485700 (WI)
The last update on file is Oct 3, 2022. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1104812171 passes the NPI check digit test The final digit 1 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 8 1 2 1 7
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 7 1 4 1 5

Sum = 49 · next multiple of 10 = 50 · check digit = 1 · actual last digit = 1

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104812171?
NPI 1104812171 is the National Provider Identifier assigned to Leonard Fagan, M.D. in Kenosha, WI. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Obstetrics & Gynecology Physician cover?
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.
How do I contact Leonard Fagan, M.D.?
The phone number on file with NPPES is (262) 697-9200, last updated Oct 3, 2022. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Leonard Fagan, M.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1104812171 a valid number?
Yes. 1104812171 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.