Active NPI
Sean E Wilson, DPM
- Foot & Ankle Surgery Podiatrist
- West Allis, WI
National Provider Identifier
1114917812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 780025
- Practice address
- 2424 S 90TH St
Suite 500
West Allis, WI 53227-2455 - Phone
- (414) 328-8600
- Fax
- (414) 328-8686
- NPI assigned
- Oct 24, 2005
- 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 |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 780025 | WI | Primary |
Addresses
Primary practice location
2424 S 90TH St
Suite 500
West Allis, WI 53227-2455
Mailing address
19475 W North Ave
Suite 201
Brookfield, WI 53045-4199
Phone (262) 780-4400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43225100 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sean.wilson.1@10114.direct.athenahealth.com |
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- William M. Scholl College of Podiatric Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
17000 W N Ave
Suite 104W
Brookfield, WI 53005-4423
Phone (262) 799-5605
Hospital & facility affiliations
- Ascension Calumet Hospital
- Orthopaedic Hospital of Wisconsin
- Ascension SE Wisconsin Hospital
- West Allis Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 16 |
| Removal of nail tissue | 123 |
| Removal or shaving of skin growth | 22 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 780025 | WI | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspen Orthopedic and Rehabilation Specalist | Past | Accepting new patients |
Interoperability endpoints
- sean.wilson.1@10114.direct.athenahealth.com
- https://fhir4.healow.com/fhir/r4/FFEGBD
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- New Berlin, WI
- NPI 1366473597
-
- Critical Access Hospital
- Chilton, WI
- NPI 1376541748
-
- Orthopaedic Surgery Physician
- New Berlin, WI
- NPI 1710520200
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Chilton, WI
- NPI 1376541748
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1427007384
-
- Rehabilitation Hospital Unit
- Brookfield, WI
- NPI 1861417362
-
- General Acute Care Hospital
- Glendale, WI
- NPI 1669584983
-
- General Acute Care Hospital
- West Allis, WI
- NPI 1407801640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1114917812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19475 W NORTH AVE",
"address_2": "SUITE 201",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530454199",
"telephone_number": "262-780-4400",
"fax_number": "262-780-4425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 S 90TH ST",
"address_2": "SUITE 500",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532272455",
"telephone_number": "414-328-8600",
"fax_number": "414-328-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SEAN",
"middle_name": "E",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "WI",
"license": "780025",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43225100",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sean.wilson.1@10114.direct.athenahealth.com",
"affiliation": "N",
"address_1": "614 Memorial Dr",
"city": "Chilton",
"state": "WI",
"country_code": "US",
"postal_code": "530141568",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.