DR. KENNETH ALAN ICZKOWSKI (MD) – Anatomic Pathology Physician, NPI 1699702373
Anatomic Pathology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
354 PATHOLOGY in WI
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Provider Addresses for DR. KENNETH ALAN ICZKOWSKI (MD)
Froedtert Hospital, 9200, West Wisconsin Avenue, Cannon Park, Wauwatosa, Milwaukee County, Wisconsin, 53226, United States
DEPARTMENT OF PATHOLOGY
MILWAUKEE, WI 532263522
Phone: (414) 805-6966
Fax: (414) 805-6980
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-10-23
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231023001842 | I | Pathology | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 143 | 60 | $0 |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 109 | 108 | $0 |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 98 | 54 | $0 |
| 88321 | Surgical pathology consultation and report on referred slides prepared elsewhere | 56 | 56 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 42 | 11 | $0 |
Insurance plans in this area (ZIP 53226)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| - | WI | |
| - | WI | |
| - | WI | |
| - | WI | |
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| Physician Assistant | WI | |
| Internal Medicine | WI | |
| Nurse Practitioner | WI | |
| Physician Assistant | WI |
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