Individual provider Active NPI

Michael R. Sween, PA

  • Medical Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1073629697
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
447 Issued in WI
Practice address
3070 N 51St St
#406
Milwaukee, WI 53210-1645
Phone
(414) 447-5040
Fax
(414) 447-5066
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 447 WI Primary

Addresses

Primary practice location

3070 N 51St St
#406
Milwaukee, WI 53210-1645

Mailing address

3070 N 51St St
#406
Milwaukee, WI 53210-1645
Phone (414) 447-5040

Other identifiers 1

IdentifierTypeStateIssuer
42984300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414000969 WI Practitioner - Physician Assistant 6901890516 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
447WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jan 1, 2004 Accepting new patients
Ascension SE Wisconsin Hospital, Inc Past Accepting new patients

Locations

19475 W North Ave
Ste 304
Brookfield, WI 53045
Phone (262) 785-2000

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

3070 N 51st St
Milwaukee, WI 53210
Phone (414) 442-9911

3070 N 51st St
Ste 406
Milwaukee, WI 53210
Phone (414) 447-2177

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

Organizations & group practices 2

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073629697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N 51ST ST",
            "address_2": "#406",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101645",
            "telephone_number": "414-447-5040",
            "fax_number": "414-447-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N 51ST ST",
            "address_2": "#406",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101645",
            "telephone_number": "414-447-5040",
            "fax_number": "414-447-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEEN",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42984300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.