Individual provider Active NPI

Peter John Rossi, M.D.

  • Vascular Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1063450229
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
47153 Issued in WI
Practice address
9200 W Wisconsin Ave
Vascular Surgery/General Surgery
Milwaukee, WI 53226-3522
Phone
(414) 805-9160
Fax
(414) 805-9170
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 47153 WI Primary
Surgery Physician 208600000X 47153 WI

Addresses

Primary practice location

9200 W Wisconsin Ave
Vascular Surgery/General Surgery
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Vascular Surgery/General Surgery
Milwaukee, WI 53226-3522
Phone (414) 805-9160

Other identifiers 2

IdentifierTypeStateIssuer
036107064MedicaidIL
1063450229MedicaidWI

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
I20090609000574 WI Practitioner - Vascular SurgeryPractitioner - General Surgery 3779596515 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

W180N8085 Town Hall Rd
FL 3
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Leg revascularization (restoring blood flow)13
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47153WIMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Surgery CurrentSince Jul 1, 2009 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Vascular Surgery CurrentSince May 22, 2013 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • Direct secure messaging: prossimd27264@direct.froedtert.com

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.

Hospital & facility affiliations 6

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1063450229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "VASCULAR SURGERY/GENERAL SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-9160",
            "fax_number": "414-805-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "VASCULAR SURGERY/GENERAL SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-9160",
            "fax_number": "414-805-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSI",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "47153",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "47153",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107064",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063450229",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.