MADISON MEDICAL AFFILIATES, INC. (NPI# 1588695746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588695746 |
| Entity Type | Organization |
| Organization Name | MADISON MEDICAL AFFILIATES, INC. |
| Practice Address |
788 N Jefferson St Suite 300/attn. Kaaren Butzen Milwaukee WI 53202-3718 |
| Practice Telephone | 4142728950 |
| Practice Fax Number | 4142252929 |
| Mailing Telephone | 4142728950 |
| Mailing Fax Number | 4142252929 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-10-21 |
| Authorized Official Name | KAAREN P. BUTZEN (CREDENTIALING) |
| Authorized Official Telephone | 4142264025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32847200 | 05 |
| Street Address |
788 N JEFFERSON ST SUITE 300/ATTN. KAAREN BUTZEN |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53202-3718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417938556 | Maria Revina Ochoa Ignacio Vitug | Internal Medicine | 788 N Jefferson St, Suite 300, Milwaukee, WI 53202-3718 | 2005-11-07 |
| 1710330725 | Major Dental Clinics of Milwaukee S.c. | Dentist | 788 N Jefferson St, Suite 880, Milwaukee, WI 53202-3718 | 2016-07-14 |
| 1174939409 | Lorraine Witt | Physician Assistant | 788 N Jefferson St, Suite 401, Milwaukee, WI 53202-3718 | 2014-07-08 |
| 1275777260 | Brent Fossum Jones | Internal Medicine | 788 N Jefferson St, Suite 201, Milwaukee, WI 53202-3718 | 2009-04-22 |
| 1548332752 | Cynthia A Koopmeiners | Physician Assistant | 788 N Jefferson St, Suite 401, Milwaukee, WI 53202-3718 | 2006-11-14 |
| 1134234776 | Abraham Varghese | Internal Medicine | 788 N Jefferson St, Suite 300, Milwaukee, WI 53202-3718 | 2006-08-21 |
| 1871501593 | Antoni Jan Gofron | Internal Medicine | 788 N Jefferson St, Suite 201, Milwaukee, WI 53202-3718 | 2006-08-05 |
| 1700809928 | Ellen Menefee | Physician Assistant | 788 N Jefferson St, Suite 401, Milwaukee, WI 53202-3718 | 2006-07-26 |
| 1659399194 | John R Betz | Internal Medicine | 788 N Jefferson St, Suite 300, Milwaukee, WI 53202-3718 | 2006-07-17 |
| 1023042249 | Aurora Pharmacy Inc | Pharmacy | 788 N Jefferson St, Milwaukee, WI 53202-3718 | 2006-07-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053958298 | Melanie Ann Pare | Occupational Therapist | 1414 N. Prospect Ave., Milwaukee, WI 53202 | 2019-12-06 |
| 1568921278 | Sword Health Inc | Health Educator | 1020 North Broadway, Milwaukee, WI 53202 | 2019-03-13 |
| 1619446408 | First Priority Home Care, LLC | Home Health | 342 W. Water Street, Suite 600, Milwaukee, WI 53202 | 2018-11-21 |
| 1346747169 | Creative Counseling of Milwaukee | Counselor | 2266 E Prospect Ave, Suite 304, Milwaukee, WI 53202 | 2018-04-09 |
| 1043692700 | Matthew Weinlander | Psychiatry & Neurology | 827 N Cass St # 9, Milwaukee, WI 53202 | 2015-06-18 |
| 1437572831 | Pathfinder Medical Group | Family Medicine | 216 Milwaukee St, Suite 2d, Milwaukee, WI 53202 | 2014-01-22 |
| 1669819785 | Kate Savage Anzia | Counselor | 2266 North Prospect Avenue, Suite 326, Ravenswood Clinic, Milwaukee, WI 53202 | 2013-05-30 |
| 1164773222 | Rutell Counseling Services, L.L.C. | Counselor | 759 N. Milwaukee St., Suite 600, Milwaukee, WI 53202 | 2012-09-28 |
| 1548563760 | Susan Rose Westergren | Pharmacist | 1400 E. Brady St, Walgreens, Milwaukee, WI 53202 | 2010-12-09 |
| 1174848816 | Brian D Eiche | Emergency Medicine | 111 E. Wisconsin Ave. Ste 2100, Infinity Healthcare, Milwaukee, WI 53202 | 2010-04-06 |
| Find all providers in zip 53202 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871769919 | Richard Winston Meyers | General Practice | 11050 Liberty Dr, Milwaukee, WI 53224-3630 | 2008-05-07 |
| 1144492273 | Amanda Courtney Reiswig | General Practice | 1233 N Mayfair Rd Ste 208, Milwaukee, WI 53226-3255 | 2008-03-28 |
| 1063496131 | Eldon J Swenson | General Practice | 620 S 76th St, Suite 240, Milwaukee, WI 53214-1599 | 2005-12-02 |
| 1467093864 | Der Yang | General Practice | 5800 W Burleigh St, Milwaukee, WI 53210-1516 | 2019-10-07 |
| 1821559550 | Kamal Sammy Al-shalby | General Practice | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2019-03-26 |
| 1659831816 | Rachel Louise Feltman-frank | General Practice | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2019-03-23 |
| 1518427145 | Zabrina Leann Ebert | General Practice | 8701 Watertown Plank Road, Milwaukee, WI 53226-0509 | 2019-03-20 |
| 1104323765 | Kayla Jean Schenheit | General Practice | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2018-04-10 |
| 1831621341 | Peter Devries | General Practice | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2017-04-03 |
| 1962934265 | Hannah M Reiland | General Practice | 8701 W Watertown Plank Rd, Department of Psychiatry and Behavioral Medicine, Milwaukee, WI 53226-3548 | 2017-03-28 |
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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.