Individual provider Active NPI

Umair Mubashar

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1083174528
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
77257 Issued in WI
Practice address
945 N 12TH St
Milwaukee, WI 53233-1305
Phone
(414) 219-2000
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 77257 WI Primary

Addresses

Primary practice location

945 N 12TH St
Milwaukee, WI 53233-1305

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 219-2000

Other practice location 1

530 New Brunswick Ave
Perth Amboy, NJ 08861-3654
Phone (732) 324-5080

Other identifiers 1

IdentifierTypeStateIssuer
100209521MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address umubashar342016@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
I20220816002007 WI Practitioner - Internal Medicine 3173906658 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

Hospital & facility affiliations

  • Aurora at Home Hospice, Wauwatosa, WI, CCN 521528
  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic LTD CurrentSince May 3, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 5, 2022 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince May 3, 2023 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince May 3, 2023 Accepting new patients
Aurora Advanced Healthcare, Inc. Internal Medicine CurrentSince May 3, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 5, 2022 Accepting new patients
Aurora Medical Group, Inc. Internal Medicine Current Accepting new patients

Locations

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

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

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

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

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

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

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

Interoperability endpoints

  • Direct secure messaging: umubashar342016@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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1083174528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-219-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 New Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Perth Amboy",
            "state": "NJ",
            "postal_code": "088613654",
            "country_code": "US",
            "telephone_number": "732-324-5080",
            "fax_number": "732-324-4669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUBASHAR",
        "first_name": "UMAIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "77257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100209521",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "umubashar342016@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "945 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "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": "945 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.