Individual provider Active NPI

Michael Mullane, MD

  • Clinical Genetics (M.D.) Physician
  • Mount Pleasant, WI
National Provider Identifier
1053302729
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
36700 Issued in WI
Practice address
8400 Washington Ave
Mount Pleasant, WI 53406-3735
Phone
(262) 884-8340
NPI assigned
Nov 2, 2005
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 36700 WI
Clinical Genetics (M.D.) Physician 207SG0201X 36700 WI Primary

Addresses

Primary practice location

8400 Washington Ave
Mount Pleasant, WI 53406-3735

Mailing address

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

Other practice location 1

1151 Warwick Way
Racine, WI 53406-5661
Phone (262) 886-7360

Other identifiers 1

IdentifierTypeStateIssuer
32142700MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmullane7512@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
I20090318000113 WI Practitioner - Medical Genetics and GenomicsPractitioner - Hematology/OncologyPractitioner - Medical Oncology 5799686648 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Genetics and GenomicsAlso: Hematology/Oncology
Education
Johns Hopkins University School of Medicine, 1985
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
Aurora Health Care Metro, Inc.Group PAC ID 8628986536, 75 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

1055 N Mayfair Rd
Suite 300
Wauwatosa, WI 53226-3436
Phone (414) 476-8450

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6000

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Aurora, LLC CurrentSince Jul 24, 2021 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Feb 1, 2010 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 10, 2025 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Feb 1, 2010 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 10, 2025 Accepting new patients
Aurora Health Care Metro, Inc. Hematology & Oncology CurrentSince Dec 18, 2011 Accepting new patients

Locations

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

4655 N Port Washington Rd
Ste 200
Glendale, WI 53212
Phone (414) 906-3420

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

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

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

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

8400 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 231-3000

8400 Washington Ave
Ste 203
Mount Pleasant, WI 53406
Phone (262) 884-8340

1151 Warwick Way
Racine, WI 53406
Phone (262) 321-6300

1055 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 476-8450

Interoperability endpoints

  • Direct secure messaging: mmullane7512@direct.myadvocateaurora.org

Organizations & group practices 7

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

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1053302729",
    "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": "8400 WASHINGTON AVE",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534063735",
            "telephone_number": "262-884-8340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 Warwick Way",
            "address_purpose": "LOCATION",
            "city": "Racine",
            "state": "WI",
            "postal_code": "534065661",
            "country_code": "US",
            "telephone_number": "262-886-7360",
            "fax_number": "262-886-7361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLANE",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "36700",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "WI",
            "license": "36700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32142700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmullane7512@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1151 Warwick Way",
            "city": "Racine",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534065661",
            "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": "1151 Warwick Way",
            "city": "Racine",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534065661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.