Individual provider Active NPI

Brett A. Linzer, M.D.

  • Internal Medicine Physician
  • Oconomowoc, WI
National Provider Identifier
1083686653
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42014 Issued in WI
Practice address
1185 Corporate Center Dr
Prohealth Care Medical Associates, Inc.
Oconomowoc, WI 53066-4887
Phone
(262) 928-8400
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42014 WI Primary
Pediatrics Physician 208000000X 42014 WI

Addresses

Primary practice location

1185 Corporate Center Dr
Prohealth Care Medical Associates, Inc.
Oconomowoc, WI 53066-4887

Mailing address

1185 Corporate Center Dr
Prohealth Care Medical Associates, Inc.
Oconomowoc, WI 53066-4887
Phone (262) 928-8400

Other identifiers 1

IdentifierTypeStateIssuer
32629400MedicaidWI

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
I20100727000860 WI Practitioner - Pediatric MedicinePractitioner - Internal Medicine 5294868378

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

725 American Ave
Waukesha, WI 53188-5031

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42014WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Emergency Associates Past Accepting new patients
Prohealth Medical Group Inc Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: blinzer15470@direct.phci.org

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.

Hospital & facility affiliations 3

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1083686653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 CORPORATE CENTER DR",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES, INC.",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664887",
            "telephone_number": "262-928-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 CORPORATE CENTER DR",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES, INC.",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664887",
            "telephone_number": "262-928-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINZER",
        "first_name": "BRETT",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "42014",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "42014",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32629400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.