AFFILIATED HEALTH OF WISCONSIN LTD. (NPI# 1063433977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063433977 |
| Entity Type | Organization |
| Organization Name | AFFILIATED HEALTH OF WISCONSIN LTD. |
| Practice Address |
2626 N 76th St Suite 105 Wauwatosa WI 53213-1137 |
| Practice Telephone | 4147747794 |
| Practice Fax Number | 4146073971 |
| Mailing Telephone | 4147747794 |
| Mailing Fax Number | 4146073971 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2014-04-21 |
| Authorized Official Name | KARIEN C BAKKER (COO) |
| Authorized Official Telephone | 4147554760 |
| Authorized Official Credential | PT, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 2471C3401X |
Radiologic Technologist Specialization: Computed Tomography |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2626 N 76TH ST SUITE 105 |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53213-1137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902385628 | Jodie Marie Daley | Radiologic Technologist | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2018-08-13 |
| 1821527623 | Jennifer Budzien | Physical Therapist | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2017-06-06 |
| 1558809020 | Vickie Radish | Radiologic Technologist | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2017-02-06 |
| 1023556586 | Marlon Williams | Physical Therapy Assistant | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2017-02-05 |
| 1124565981 | Gina Cifaldi | Radiologic Technologist | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2017-01-31 |
| 1528424249 | Kellie Rae Hanson | Physical Therapist | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2016-01-11 |
| 1235530502 | Kristin Sendzik | Physical Therapist | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2014-09-05 |
| 1114336385 | Eric Demshar | Physical Therapist | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2014-08-12 |
| 1043641194 | Ingrid L Barber | Physical Therapy Assistant | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2013-11-27 |
| 1003116765 | Jay L. Mackman, Dds | Dentist | 2626 N 76th St, Wauwatosa, WI 53213-1137 | 2010-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932682473 | Tracy A Bolton | Nurse Practitioner | 2626 N 76th St Ste 101, Wauwatosa, WI 53213 | 2018-09-11 |
| 1609309129 | Anupriya Dayal | Student in an Organized Health Care Education/Training Program | 7700 Portland Avenue, #227, Milwaukee, WI 53213 | 2017-04-11 |
| 1407202666 | Michael Lenz | Dentist | 1221 N 62nd Street, 201, Wauwatosa, WI 53213 | 2016-05-06 |
| 1164807889 | Myia Mitchell | Massage Therapist | 6012 W. North Avenue, Milwaukee, WI 53213 | 2015-07-23 |
| 1518369420 | Rachel Rakow | Speech-Language Pathologist | 1009 N 92nd St, Wauwatosa, WI 53213 | 2014-09-23 |
| 1821348335 | Mary Kathryn Maxey | Dietitian, Registered | 1515 Mower Court, Wauwatosa, WI 53213 | 2012-09-12 |
| 1134478506 | Andrea Brooke Moosreiner | Dietitian, Registered | 7220 Milwaukee Ave, Wauwatosa, WI 53213 | 2012-08-31 |
| 1467726075 | Stephanie Miller | Social Worker | 2618 N 61st St, Milwaukee, WI 53213 | 2012-02-28 |
| 1396013447 | Ng Enterprise, Inc. | Home Health | 7635 West Bluemound Road, Suite 1b, Milwaukee, WI 53213 | 2011-12-05 |
| 1184908162 | Lisa Anne Behlmer | Pharmacist | 6600 W. State St, Wauwatosa, WI 53213 | 2011-10-07 |
| Find all providers in zip 53213 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295894640 | Rae Jean Muchenberger | Physical Medicine & Rehabilitation | 8802 W Becher, West Allis, WI 53227-1628 | 2006-12-08 |
| 1366473597 | Aspen Orthopedic and Rehabilation Specalist | Physical Medicine & Rehabilitation | 19475 W. North Ave, Suite 201, Brookfield, WI 53045-4199 | 2006-07-05 |
| 1881681294 | Kenneth L Klein | Physical Medicine & Rehabilitation | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2005-09-30 |
| 1053955682 | Kayla Smith | Physical Medicine & Rehabilitation | 1700 W Bender Rd, Glendale, WI 53209-3852 | 2019-11-06 |
| 1609220664 | Chen Cui | Physical Medicine & Rehabilitation | 600 Highland Ave, Madison, WI 53792-9055 | 2016-04-15 |
| 1477948834 | Brittany Bickelhaupt | Physical Medicine & Rehabilitation | 225000 Hummingbird Rd, Wausau, WI 54401-2948 | 2015-04-02 |
| 1881034627 | Matthew James Kortes | Physical Medicine & Rehabilitation | 500 E Veterans St, Tomah, WI 54660-3105 | 2013-06-25 |
| 1285908970 | Baycare Clinic, LLP | Physical Medicine & Rehabilitation | 2401 Holmgren Way, Green Bay, WI 54304-5224 | 2012-02-28 |
| 1376738336 | Oscar C Wille | Physical Medicine & Rehabilitation | 2301 N Lake Dr, Milwaukee, WI 53211-4508 | 2007-09-12 |
| 1427102631 | Susan L Husslein | Physical Medicine & Rehabilitation | 8802 W Becher St, West Allis, WI 53227 | 2007-01-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.