Michael James Ewing, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

27966020 Issued in WI

Practice address

3734 W Wisconsin Ave
Milwaukee, WI 53208-3153

Phone

(414) 344-6111

Fax

(414) 344-2191

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• 16TH Street Community Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1417912999
  Medicare reassignment NPD
• Wisconsin Community Services Inc.

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1538389184
  Medicare reassignment NPD
• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1316587439
  NPD
• Wisconsin Community Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1417108747
  NPD
• Ravenswood Clinic Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1285716308
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1104922525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083153",
            "telephone_number": "414-344-6111",
            "fax_number": "414-344-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083153",
            "telephone_number": "414-344-6111",
            "fax_number": "414-344-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWING",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "27966020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30798300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evolve Physical Therapy and Sports Medicine LLC
• Evolve Therapy Services LLC
• Griffin A Ewald, PT
• Kenneth Paul Ewert, BCBA
• Ewing Consulting LLC
• William David Ewing III
• Courtney Ewoldt
• Stephanie Examitas, RN
• Exceptional Care L.L.C.
• Exceptional Health Network LLC

• Psychiatry Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.