Active NPI
Anthony Norelli, M.D.
- Family Medicine Physician
- Mukwonago, WI
National Provider Identifier
1093788176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35163
- Practice address
- Prohealth Care Medical Centers-Mukwonago
240 Maple Avenue
Mukwonago, WI 53149 - Phone
- (262) 928-1900
- Fax
- (262) 363-1949
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35163 | WI | Primary |
Addresses
Primary practice location
Prohealth Care Medical Centers-Mukwonago
240 Maple Avenue
Mukwonago, WI 53149
Mailing address
Waukesha Health Care Inc.
N17 W24100 Riverwood Drive Suite 250
Waukesha, WI 53188-1177
Phone (262) 928-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32145100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35163 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192579200000",
"number": "1093788176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WAUKESHA HEALTH CARE INC.",
"address_2": "N17 W24100 RIVERWOOD DRIVE SUITE 250",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531881177",
"telephone_number": "262-928-4100",
"fax_number": "262-928-5835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PROHEALTH CARE MEDICAL CENTERS-MUKWONAGO",
"address_2": "240 MAPLE AVENUE",
"city": "MUKWONAGO",
"state": "WI",
"postal_code": "53149",
"telephone_number": "262-928-1900",
"fax_number": "262-363-1949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORELLI",
"first_name": "ANTHONY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2007-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "35163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32145100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mukwonago, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.