Individual provider Active NPI

Michelle L Martin, APNP

  • Nurse Practitioner
  • New Berlin, WI
National Provider Identifier
1053159269
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15600 Issued in WI
Practice address
14555 W National Ave
New Berlin, WI 53151-4494
Phone
(262) 827-2955
NPI assigned
Jul 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15600 WI Primary

Addresses

Primary practice location

14555 W National Ave
New Berlin, WI 53151-4494

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

16985 W Bluemound Rd
Brookfield, WI 53005-5909
Phone (262) 641-8400

Other practice location 2

9200 W Loomis Rd Ste 212
Franklin, WI 53132-9600
Phone (414) 529-9200

Other practice location 3

6901 W Edgerton Ave
Greenfield, WI 53220-4420
Phone (414) 421-8400

Other identifiers 1

IdentifierTypeStateIssuer
100291903MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmartin49142@direct.aurora.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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023002797 WI Practitioner - Nurse Practitioner 6800329384 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

1575 N Rivercenter Dr
Milwaukee, WI 53212-3978
Phone (414) 283-8444

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15600WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Nov 1, 2024 Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince Nov 1, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Nov 1, 2024 Accepting new patients

Locations

16985 W Bluemound Rd
Brookfield, WI 53005
Phone (262) 641-8400

9200 W Loomis Rd
Ste 212
Franklin, WI 53132
Phone (414) 427-3258

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

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

6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1721433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1053159269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514494",
            "telephone_number": "262-827-2955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16985 W Bluemound Rd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055909",
            "country_code": "US",
            "telephone_number": "262-641-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Loomis Rd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "WI",
            "postal_code": "531329600",
            "country_code": "US",
            "telephone_number": "414-529-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6901 W Edgerton Ave",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532204420",
            "country_code": "US",
            "telephone_number": "414-421-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-20",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "15600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100291903",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmartin49142@direct.aurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14555 W National Ave",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531514494",
            "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": "14555 W National Ave",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531514494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.