William R. Cooper, MD
Individual provider Active NPI Internal Medicine Physician · Oconomowoc, WI
NPI 1023078037 · NPPES record last updated Apr 16, 2012
Key facts
- NPI
- 1023078037
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 49183 (WI)
- Practice address
- 1185 Corporate Center Dr Ste 175
Prohealth Care Medical Associates Inc.
Oconomowoc, WI 53066-4889 - Phone
- (262) 928-8400
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 11
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Wisconsin School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prohealth Medical Group Inc
Practice addresses (Care Compare)
1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400
N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808
N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704
Hospital & facility affiliations
- Prohealth Home Care
- Preceptor Home Health
- Agrace Hospicecare
- Legacy Hospice
- Brighton Hospice Wisconsin
- Vitas Healthcare Corp Midwest
- Prohealth Home Hospice
- Waukesha Memorial Hospital
- Oconomowoc Memorial Hospital
- Shorehaven HLTH & Rehab CTR
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Shorehaven Health and Rehabilitation Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Nov 27, 2024 Dec 5, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060817000516 | WI | Practitioner - Internal Medicine | 3870575244 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49183 | WI | MD | Internal Medicine Physician |
| 6367 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Internal Medicine | Current |
Accepting new patients |
| Prohealth Medical Group Inc. | Internal Medicine | Current |
Accepting new patients |
| Lutheran Homes of Oconomowoc Inc. | Past | Accepting new patients | |
| Prohealth Medical Group Inc | Internal Medicine | Past | Accepting new patients |
Locations
2750 Golf Rd
Delafield, WI 53018
Phone (262) 928-4900
820 Summit Ave
Oconomowoc, WI 53066
Phone (262) 567-0223
1185 Corporate Center Dr
Ste 175
Oconomowoc, WI 53066
Phone (262) 928-6236
N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
Interoperability endpoints
- wcooper15467@direct.phci.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 49183 | WI | Yes |
Addresses
Primary practice location
1185 Corporate Center Dr Ste 175
Prohealth Care Medical Associates Inc.
Oconomowoc, WI 53066-4889
Mailing address
1185 Corporate Center Dr Ste 175
Prohealth Care Medical Associates Inc.
Oconomowoc, WI 53066-4889
Phone (262) 928-8400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 328213900 | Medicaid | MN |
Other providers in Oconomowoc, WI
- Coachflow Medical Corporation
- Frieda Marie Coakley
- Carla Colella
- Complete Chiropractic and Rehab Center LLC
- Eric P Conradson
- Christina Copoulos-Swanson
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Judie V Cotey
All providers in Oconomowoc, WI · Internal Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.