NPIMap

Individual provider Active NPI

Brian J Demaster, MD

  • Family Medicine Physician
  • Cedar Grove, WI
National Provider Identifier
1043325293
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34619 Issued in WI
Doing business as
Brian Jon Demaster
Practice address
313 S Main St
Cedar Grove, WI 53013
Phone
(920) 668-8502
Fax
(920) 668-8093
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34619 WI Primary

Addresses

Primary practice location

313 S Main St
Cedar Grove, WI 53013

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 647-6326

Other identifiers 1

IdentifierTypeStateIssuer
32539500MedicaidWI

Other names 1

  • Brian Jon Demaster Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bdemaster45079@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100609000603 WI Practitioner - Family Practice 1355471822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

110 Butler St
Random Lake, WI 53075-1708
Phone (920) 994-9094

2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Phone (920) 457-4461

313 S Main St
Cedar Grove, WI 53013-1611
Phone (920) 668-8502

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34619WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 6, 1999 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 6, 1999 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

313 S Main St
Cedar Grove, WI 53013
Phone (414) 668-8502

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

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

620 S Wisconsin Dr
Sheboygan, WI 53083
Phone (920) 565-4595

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043325293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-647-6326",
            "fax_number": "414-671-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S MAIN ST",
            "city": "CEDAR GROVE",
            "state": "WI",
            "postal_code": "53013",
            "telephone_number": "920-668-8502",
            "fax_number": "920-668-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMASTER",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-03-07",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "34619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32539500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdemaster45079@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "313 S Main St",
            "city": "Cedar Grove",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53013",
            "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": "313 S Main St",
            "city": "Cedar Grove",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRIAN",
            "last_name": "DEMASTER",
            "middle_name": "JON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Grove, WI

Sources for this page

Verify at the official NPI Registry.