Marshal Jay Mirviss (NPI# 1205820958, PAC ID# 0648182303) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1205820958 |
| PAC ID by PECOS | 0648182303 |
| Professional Enrollment ID | I20080820000488 |
| Full Name | Marshal Jay Mirviss |
| Organization Legal Name | ASCENSION MEDICAL GROUP SOUTHEAST WISCONSIN INC |
| Address |
2500 W Layton Ave Suite 10 Milwaukee WI 53221-5400 |
| Phone Number | 4142822006 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF WISCONSIN |
| Graduation Year | 1975 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 8628980943 |
| Number of Group Practice Members | 586 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520078 | WHEATON FRANCISCAN HEALTHCARE ST FRANCIS |
| 520136 | WHEATON FRANCISCAN ST JOSEPH |
| 520138 | AURORA ST LUKES MEDICAL CENTER |
| 520177 | FROEDTERT MEMORIAL LUTHERAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2500 W Layton Ave, Suite 10, Milwaukee, WI 53221-5400 | 4142822006 | ASCENSION MEDICAL GROUP SOUTHEAST WISCONSIN INC |
| Organization Legal Name | ASCENSION MEDICAL GROUP SOUTHEAST WISCONSIN INC |
| Physicians | 462 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Neal James Campbell Ii | Family Medicine | Ascension Medical Group Southeast Wisconsin Inc | 3610 Michelle Witmer Memorial Dr, New Berlin, WI 53151-5292 |
| David James Coulter | Cardiovascular Disease (cardiology) | Ascension Medical Group Southeast Wisconsin Inc | 2025 W Oklahoma Ave, Suite 105, Milwaukee, WI 53215-4455 |
| Danielle L Laczniak | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 3070 N 51st St, Suite 601, Milwaukee, WI 53210-1663 |
| Lisa Marie Leblanc | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 3040 N 117th St, Suite 200, Wauwatosa, WI 53222-4129 |
| Jorja K Mueller | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 7400 W Rawson Ave, Suite G40, Franklin, WI 53132-8114 |
| Breana C Cummens | Family Medicine | Ascension Medical Group Southeast Wisconsin Inc | 4600 W Loomis Rd, Greenfield, WI 53220-4858 |
| Katie L Leiteritz | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 8020 S Howell Ave, Oak Creek, WI 53154-2930 |
| Brian Zafonte | Hand Surgery | Ascension Medical Group Southeast Wisconsin Inc | 3811 Spring St, Suite 102, Mount Pleasant, WI 53405-1667 |
| Irina Ciubotaru | Endocrinology | Ascension Medical Group Southeast Wisconsin Inc | 3805 Spring St, Suite 310, Mount Pleasant, WI 53405-1600 |
| Carlos R Galvao Sobrinho | Nephrology | Ascension Medical Group Southeast Wisconsin Inc | 3805 B Spring St, Suite 260, Mount Pleasant, WI 53405-1643 |
| Street Address |
2500 W LAYTON AVE SUITE 10 |
| City | MILWAUKEE |
| State | WI |
| Zip | 53221-5400 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Constance M Ganapes | Internal Medicine | Primary Care of Milwaukee Sc | 2500 W Layton Ave, Suite 290, Milwaukee, WI 53221-5400 |
| Ram K Mittal | General Surgery | Azh Vascular Center Mke LLC | 2500 W Layton Ave, Suite 40, Milwaukee, WI 53221-5420 |
| Joseph Gerard Trojan | Internal Medicine | Ascension Medical Group Southeast Wisconsin Inc | 2500 W Layton Ave, Suite 10, Milwaukee, WI 53221-5400 |
| Victoria J Magnan | Occupational Therapy | Azh Wound Center Mke LLC | 2500 W Layton Ave, Suite 30, Milwaukee, WI 53221-5436 |
| Mary B Snell | Internal Medicine | Ascension Medical Group Southeast Wisconsin Inc | 2500 W Layton Ave, Suite 10, Milwaukee, WI 53221-5400 |
| James Mazzulla | Internal Medicine | Primary Care of Milwaukee Sc | 2500 W Layton Ave, Suite 290, Milwaukee, WI 53221-5400 |
| Lynette A Gerke | Physical Therapy | Ascension Medical Group Southeast Wisconsin Inc | 2500 W Layton Ave, Suite 160, Milwaukee, WI 53221-5421 |
| Awais H Siddique | Interventional Radiology | Azh Vascular Center Mke LLC | 2500 W Layton Ave, Suite 40, Milwaukee, WI 53221-5420 |
| Jeffrey A Niezgoda | Emergency Medicine | Azh Wound Center Mke LLC | 2500 W Layton Ave, Suite 30, Milwaukee, WI 53221-5436 |
| Timothy J Henke | Podiatry | Advanced Foot and Ankle of Wisconsin LLC | 2500 W Layton Ave, Suite 170, Milwaukee, WI 53221-5433 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amelia E Tollefson | Nurse Practitioner | Minuteclinic Diagnostic of Wisconsin LLC | 3860 S 27th St, Milwaukee, WI 53221-1307 |
| Jamie L Bonoris | Nurse Practitioner | Minuteclinic Diagnostic of Wisconsin LLC | 3860 S 27th St, Milwaukee, WI 53221-1307 |
| Tristah R Romero-kelly | Nurse Practitioner | Minuteclinic Diagnostic of Wisconsin LLC | 3860 S 27th St, Milwaukee, WI 53221-1307 |
| Sylvestra Ramirez | Physical Therapy | 3906 S 27th St, Milwaukee, WI 53221-1826 | |
| Walter I Melnyczenko | Obstetrics/gynecology | 4220 S 27th St, Suite 101, Milwaukee, WI 53221-1855 | |
| David J Pencikowski | Nurse Practitioner | Aurora Medical Group Inc | 4131 W Loomis Rd, Greenfield, WI 53221-2006 |
| Brenda Beth Mittelsteadt | Nurse Practitioner | Advanced Pain Management Sc | 4131 W Loomis Rd, Suite 240, Greenfield, WI 53221-2059 |
| Joanne V Kostowicz-volm | Nurse Practitioner | Advanced Pain Management Sc | 4131 W Loomis Rd, Suite 240, Greenfield, WI 53221-2059 |
| Mary M Papandria | Psychologist, Clinical | Advanced Pain Management Sc | 4131 W Loomis Rd, Suite 240, Greenfield, WI 53221-2059 |
| Jennifer Marie Calmes | Nurse Practitioner | Advanced Pain Management Sc | 4131 W Loomis Rd, Suite 240, Greenfield, WI 53221-2059 |
| Find all physicians in zip 53221 | |||
| City | MILWAUKEE |
| Zip Code | 53221 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | MILWAUKEE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Marshal Jay Mirviss.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.