Individual provider Active NPI

Elizabeth Gayle Masterson, MD

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1093211658
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
72446 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 955-8664
Fax
(414) 955-0064
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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 72446 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 955-8664

Other identifiers 1

IdentifierTypeStateIssuer
1093211658MedicaidWI

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
I20210701001934 WI Practitioner - Family Practice 6507267267 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Central Michigan College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outreach Community Health Centers IncGroup PAC ID 1355247735, 53 clinicians
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

1316 W Forest Home Ave
Suite a
Milwaukee, WI 53204-3227
Phone (414) 424-5000

220 W Capitol Dr
Milwaukee, WI 53212-1185
Phone (414) 727-6320

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72446WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Jun 23, 2021 Accepting new patients
Outreach Community Health Centers, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2025 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2025 Accepting new patients
Outreach Community Health Centers, Inc CurrentSince Aug 1, 2025 Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine CurrentSince Sep 15, 2025 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine CurrentSince Jun 23, 2021 Accepting new patients

Locations

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

220 W Capitol Dr
Glendale, WI 53212
Phone (414) 964-9018

2400 W Villard Ave
Glendale, WI 53209
Phone (414) 527-8000

1316 W Forest Home Ave
Ste A
Milwaukee, WI 53204
Phone (414) 424-5000

1121 E North Ave
Milwaukee, WI 53212
Phone (414) 267-6500

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

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

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

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • Direct secure messaging: emasterson957360@direct.froedtert.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1093211658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-955-8664",
            "fax_number": "414-955-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-955-8664",
            "fax_number": "414-955-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "ELIZABETH",
        "middle_name": "GAYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "72446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093211658",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.