Active NPI
Mary Katherine Kautz, APNP
- Gerontology Nurse Practitioner
- Mequon, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 3526-33
- Practice address
- 13133 N Port Washington Rd
Suite 122
Mequon, WI 53097-2419 - Phone
- (262) 243-3700
- Fax
- (262) 243-3701
- NPI assigned
- Dec 9, 2008
- Last updated
- Oct 31, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 3526-33 | WI | Primary |
Addresses
Primary practice location
13133 N Port Washington Rd
Suite 122
Mequon, WI 53097-2419
Mailing address
4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (262) 243-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300
13133 N Port Washington Rd
Suite G06
Mequon, WI 53097-2421
Phone (262) 243-8371
2301 N Lake Dr
Milwaukee, WI 53211-4508
2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1000
801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3526-33 | WI | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia St. Mary's Hospital Milwaukee, Inc | Current | Accepting new patients | |
| Columbia St. Mary's Hospital Milwaukee, Inc | Current | Accepting new patients | |
| Columbia St. Mary's Hospital Milwaukee Inc | Current | Accepting new patients | |
| Columbia St. Mary's Hospital Milwaukee, Inc | Past | Accepting new patients |
Locations
13133 N Port Washington Rd
Ste 122
Mequon, WI 53097
Phone (262) 243-3700
13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300
801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ascension Columbia St Mary's Hospital Milwaukee
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1023064482
-
dba Ascension Columbia St Mary's Hospital Ozaukee
- Psychiatric Hospital Unit
- Mequon, WI
- NPI 1417600909
-
dba Ascension Columbia St Mary's Hospital Milwaukee
- Multi-Specialty Clinic/Center
- Glendale, WI
- NPI 1215945456
-
dba Ascension Columbia St Mary's Hospital Milwaukee
- Multi-Specialty Clinic/Center
- Mequon, WI
- NPI 1710928221
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ascension SE Wisconsin Hospital-Elmbrook Campus
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1427007384
-
dba Ascension SE Wisconsin Hospital-Elmbrook Campus
- Rehabilitation Hospital Unit
- Brookfield, WI
- NPI 1861417362
-
dba Ascension Columbia St Mary's Hospital Milwaukee Campus
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1871656082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1013152743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 N PORT WASHINGTON RD",
"address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532121082",
"telephone_number": "262-243-3700",
"fax_number": "262-243-3701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13133 N PORT WASHINGTON RD",
"address_2": "SUITE 122",
"city": "MEQUON",
"state": "WI",
"postal_code": "530972419",
"telephone_number": "262-243-3700",
"fax_number": "262-243-3701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUTZ",
"first_name": "MARY",
"middle_name": "KATHERINE",
"name_prefix": "Mrs.",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-09",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WI",
"license": "3526-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mequon, WI
- Katz-Gilbertson Psychotherapy Associates, LLC
- Ceva Ruby Katz, PHD PSYCHOLOGIST
- Jonathan Katz, MD
- Cindy Schultz Katzoff, M.A. SLP/CCC
- Kawaljeet Kaur, M.D.
- Austin Donald Carl Kayser, MD
- Kazco Inc (A Better Solution In Home Care)
- Christopher Kearns, MD
- Heidi N. Keller, PA-C
- Kelly Duggan Consultation Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.