Individual provider Active NPI

Michael B Wood, PA-C

  • Physician Assistant
  • West Allis, WI
National Provider Identifier
1053472878
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2170-23 Issued in WI
Practice address
6609 W Greenfield Ave
West Allis, WI 53214-4958
Phone
(414) 257-8577
NPI assigned
Dec 13, 2006
Last updated
May 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2170-23 WI Primary

Addresses

Primary practice location

6609 W Greenfield Ave
West Allis, WI 53214-4958

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (414) 257-8577

Other practice location 1

6308 8th Ave
Kenosha, WI 53143-5031
Phone (414) 290-6720

Other identifiers 1

IdentifierTypeStateIssuer
41947300MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mwood154046@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071102000197 WI Practitioner - Physician Assistant 9931101144 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

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

200 E Ryan Rd
Oak Creek, WI 53154-4563
Phone (414) 570-3590

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince May 5, 2023 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince May 5, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 5, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 5, 2023 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince May 5, 2023 Accepting new patients
Ihc-Libertyville Emergency Physicians, LLC Physician Assistant Past Accepting new patients
Women's Doc of Elgin, S. C. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

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

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

7401 104th Ave
#110
Kenosha, WI 53142
Phone (262) 764-5595

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

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

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

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

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

W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000

6609 W Greenfield Ave
West Allis, WI 53214
Phone (414) 257-8500

Interoperability endpoints

  • Direct secure messaging: michael.wood.p1@direct.comportho.nextgenshare.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1053472878",
    "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": "414-257-8577",
            "fax_number": "414-257-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144958",
            "telephone_number": "414-257-8577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6308 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531435031",
            "country_code": "US",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2170-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41947300",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwood154046@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6609 W Greenfield Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532144958",
            "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": "6609 W Greenfield Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532144958",
            "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.