Individual provider Active NPI

Bridget H Johnson, MD

  • Anesthesiology Physician
  • Waukesha, WI
National Provider Identifier
1104042613
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
51994-20 Issued in WI
Practice address
725 S American Avenue
Waukesha, WI 53188-5031
Phone
(262) 544-2011
Fax
(262) 439-7683
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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 125051278 IL
Anesthesiology Physician 207L00000X 51994-20 WI Primary

Addresses

Primary practice location

725 S American Avenue
Waukesha, WI 53188-5031

Mailing address

225 S Executive Drive
Brookfield, WI 53005-4257
Phone (262) 787-4050

Other names 1

  • Bridget Eileen Hegarty Former name

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
I20110831000292 WI Practitioner - AnesthesiologyPractitioner - Pain Management 0042480063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anex, S.C.Group PAC ID 4486540556, 38 clinicians

Practice addresses (Care Compare)

725 S American Ave
Waukesha, WI 53188-5301
Phone (262) 544-2011

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51994-20WIMDAnesthesiology Physician
125051278ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Anesthesiology Current Accepting new patients
Midwest Physicians Anesthesia Service, SC Anesthesiology CurrentSince Oct 1, 2019 Accepting new patients
Anex, S.C. Anesthesiology CurrentSince Jul 1, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Dec 20, 2011 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine CurrentSince Dec 20, 2011 Accepting new patients

Locations

225 S Executive Dr
Brookfield, WI 53005
Phone (262) 787-4026

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

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616

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

Bin 88836
Milwaukee, WI 53288

Bin 88871
Milwaukee, WI 53288

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

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

1111 Delafield St
Waukesha, WI 53188
Phone (262) 542-0074

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

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

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Organizations & group practices 5

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1104042613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S EXECUTIVE DRIVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054257",
            "telephone_number": "262-787-4050",
            "fax_number": "262-439-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S AMERICAN AVENUE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-544-2011",
            "fax_number": "262-439-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIDGET",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125051278",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "51994-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGET",
            "last_name": "HEGARTY",
            "middle_name": "EILEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.