NPIMap

Individual provider Active NPI

Kathleen A Brass, M.D., PHD

  • Family Medicine Physician
  • Waukesha, WI
National Provider Identifier
1083815690
Registry record updated Jan 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
52837-20 Issued in WI
Practice address
2130 Big Bend Rd
Prohealth Care Medical Associates
Waukesha, WI 53189-7624
Phone
(262) 928-7555
NPI assigned
May 30, 2007
Last updated
Jan 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 52837-20 WI Primary

Addresses

Primary practice location

2130 Big Bend Rd
Prohealth Care Medical Associates
Waukesha, WI 53189-7624

Mailing address

2130 Big Bend Rd
Prohealth Care Medical Associates
Waukesha, WI 53189-7624
Phone (262) 928-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091007000605 WI Practitioner - Family Practice 0840336780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

222 Park PL
Waukesha, WI 53186-4858
Phone (651) 631-6570

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52837-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 29, 2017 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 29, 2017 Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine Current Accepting new patients
Prohealth Medical Group Inc Family Medicine Past Accepting new patients
Community Memorial Hospital of Menomonee Falls, Inc Family Medicine Past Accepting new patients

Locations

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

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Interoperability endpoints

  • Direct secure messaging: kbrass15449@direct.phci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1083815690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 BIG BEND RD",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897624",
            "telephone_number": "262-928-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 BIG BEND RD",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897624",
            "telephone_number": "262-928-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASS",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "52837-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.