Organization Active NPI

Mary M. Milbrath, MD, SC

  • Otolaryngology Physician
  • Brookfield, WI
National Provider Identifier
1043337041
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MARY M. MILBRATH, MD, SC
Practice address
19475 W North Ave
Suite 301
Brookfield, WI 53045-4199
Phone
(262) 780-4444
Fax
(262) 780-4329
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary M. Milbrath, MDNPI 1659365534
Title
President
Phone
(262) 780-4444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

19475 W North Ave
Suite 301
Brookfield, WI 53045-4199

Mailing address

19475 W North Ave
Suite 301
Brookfield, WI 53045-4199
Phone (262) 780-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100205000098 WI Part B Supplier - Clinic/Group Practice 2668515115 Receives reassigned benefits from 1 practitioner
Practice locations: Brookfield, WI

National Provider Directory

National Provider Directory

Locations

104 E Summit Ave
Ste 2
Wales, WI 53183
Phone (262) 968-5500

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043337041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19475 W NORTH AVE",
            "address_2": "SUITE 301",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454199",
            "telephone_number": "262-780-4444",
            "fax_number": "262-780-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19475 W NORTH AVE",
            "address_2": "SUITE 301",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454199",
            "telephone_number": "262-780-4444",
            "fax_number": "262-780-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY M. MILBRATH, MD, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILBRATH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-780-4444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.