ASCENSION MEDICAL GROUP - SOUTHEAST WISCONSIN, INC. (NPI# 1609881077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609881077 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP - SOUTHEAST WISCONSIN, INC. |
| Other Organization Name | ASCENSION MEDICAL GROUP |
| Practice Address |
400 W River Woods Pkwy Glendale WI 53212 |
| Mailing Address |
400 W River Woods Pkwy Glendale WI 53212-1060 |
| Practice Telephone | 4144653000 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | JONATHAN W SOHN (CFO) |
| Authorized Official Telephone | 4144653000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | MIDWEST CLINICAL LABS | 000085375 | 01 |
| WI | 32833500 | 05 |
| Other Name | Type Code |
|---|---|
| Ascension Medical Group | Doing Business As Name - Organization |
| Street Address |
400 W RIVER WOODS PKWY |
| City | GLENDALE |
| State | WI |
| Zip Code | 53212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447812979 | Rebecca Ann Caples | Physician Assistant | 400 W River Woods Pkwy, Glendale, WI 53212-1060 | 2019-07-04 |
| 1780792713 | Lisa Suzanne-poss Benson | Internal Medicine | 400 W River Woods Pkwy, Glendale, WI 53212-1060 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481001 | Beth Leanna | Counselor | Benedict Center 1849 N Dr. Marin Luther King Dr., Suite 101, Milwaukee, WI 53212 | 2020-09-11 |
| 1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1386293330 | Rachel Mae Nelson Bagha | Student in an Organized Health Care Education/Training Program | 1849 N Doctor M.l.k. Jr Dr #101, Milwaukee, WI 53212 | 2019-09-11 |
| 1164085205 | Mary Sue Daase Bowen | Counselor | 2821 N 4th Street, Milwaukee, WI 53212 | 2019-04-15 |
| 1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
| 1710447701 | Scott William Stauder | Student in an Organized Health Care Education/Training Program | 1121 E. North Ave., Milwaukee, WI 53212 | 2019-03-25 |
| 1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
| 1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
| 1093285140 | Megan Marie Volp | Advanced Practice Midwife | 2555 N Doctor M.l.k. Jr Dr, Milwaukee, WI 53212 | 2018-12-03 |
| Find all providers in zip 53212 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
| 1962017269 | One Primary Care Inc. | Internal Medicine | 800 S Central Ave Ste 212, Glendale, CA 91204-4388 | 2020-09-14 |
| 1831704063 | New Horizon Medical Center, Inc. | Internal Medicine | 1101 N Pacific Ave Ste 103, Glendale, CA 91202-4312 | 2020-09-14 |
| 1043848062 | Jennifer Huddleston, Physician Assistant PC | Internal Medicine | 1560 E Chevy Chase Dr Ste 200, Glendale, CA 91206-4140 | 2020-03-27 |
| 1679120463 | Eruman, Pllc | Internal Medicine | 18275 N 59th Ave Ste G138, Glendale, AZ 85308-1260 | 2019-08-26 |
| 1033672738 | First Step Medical LLC | Internal Medicine | 5620 W Thunderbird Rd Ste E5, Glendale, AZ 85306-4651 | 2019-04-09 |
| 1760901375 | Western Medical LLC | Internal Medicine | 21554 N 57th Ave, Glendale, AZ 85308 | 2017-09-14 |
| 1487187910 | Daniel Adam Davis | Internal Medicine | 11851 N 51st Ave Ste B110, Glendale, AZ 85304-2823 | 2017-04-11 |
| 1104212422 | Robert Allen | Internal Medicine | 1731 N Pacific Ave, Glendale, CA 91202-1108 | 2015-04-14 |
| 1790185403 | Us Housecalls, Inc. | Internal Medicine | 7881 81st St, 1st Floor, Glendale, NY 11385-7652 | 2014-08-29 |
| 1265842389 | Hani Rashid | Internal Medicine | 5681 W Beverly Ln Ste 100, Glendale, AZ 85306-9800 | 2014-04-28 |
| Find all providers in GLENDALE | ||||
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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.