Individual provider Active NPI

Daniel M Smullen, M.D.

  • Anesthesiology Physician
  • West Allis, WI
National Provider Identifier
1043245376
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
46773-020 Issued in WI
Practice address
8901 W Lincoln Ave
2ND FL
West Allis, WI 53227-2409
Phone
(414) 329-4300
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 46773-020 WI Primary

Addresses

Primary practice location

8901 W Lincoln Ave
2ND FL
West Allis, WI 53227-2409

Mailing address

8901 W Lincoln Ave
2ND FL
West Allis, WI 53227-2409
Phone (414) 329-4300

Other identifiers 2

IdentifierTypeStateIssuer
P00352772OtherRAIL ROAD MEDICARE
1043245376MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dsmullen47438@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061218000329 WI Practitioner - Anesthesiology 5698774701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Wisconsin School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5930

Hospital & facility affiliations

  • Aurora Medical Center - Summit Hospital, Summit, WI, CCN 520206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46773-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Milwaukee Anes Consultants LTD Anesthesiology Past Accepting new patients

Locations

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

8901 W Lincoln Ave
Fl 2
West Allis, WI 53227
Phone (414) 328-7700

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1043245376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 W LINCOLN AVE",
            "address_2": "2ND FL",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272409",
            "telephone_number": "414-329-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W LINCOLN AVE",
            "address_2": "2ND FL",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272409",
            "telephone_number": "414-329-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMULLEN",
        "first_name": "DANIEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "46773-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00352772",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043245376",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsmullen47438@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8901 W Lincoln Ave",
            "address_2": "2nd Fl",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "8901 W Lincoln Ave",
            "address_2": "2nd Fl",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.