Individual provider Active NPI

Venkata K Thota, MD

  • Family Medicine Physician
  • Greenfield, WI
National Provider Identifier
1134183783
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28604 Issued in WI
Practice address
4448 W. Loomis Rd.
Ste 100
Greenfield, WI 53220-4851
Phone
(414) 281-5150
Fax
(414) 281-5767
NPI assigned
Apr 12, 2006
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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 28604 WI Primary

Addresses

Primary practice location

4448 W. Loomis Rd.
Ste 100
Greenfield, WI 53220-4851

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 1

IdentifierTypeStateIssuer
31484200MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address vthota23304@direct.myadvocateaurora.org Direct

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
I20040317001176 WI Practitioner - Family PracticePractitioner - Geriatric Medicine 2961395421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

4448 W Loomis Rd
Greenfield, WI 53220-4800
Phone (414) 281-5150

6901 W Edgerton Ave
Milwaukee, WI 53220-4420
Phone (414) 421-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28604WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC Family Medicine CurrentSince Mar 1, 1996 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2007 Accepting new patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2007 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

2801 W Kinnickinnic River Pkwy
Ste 250
Milwaukee, WI 53215
Phone (414) 649-3354

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

4448 W Loomis Rd
Ste 100
Milwaukee, WI 53220
Phone (414) 281-5150

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2801 S Moorland Rd
New Berlin, WI 53151
Phone (262) 860-7800

100 15th Ave
South Milwaukee, WI 53172
Phone (414) 764-3241

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

915 Summit Ave
Summit, WI 53066
Phone (262) 569-2300

620 15th Ave
Union Grove, WI 53182
Phone (262) 878-1211

Interoperability endpoints

  • Direct secure messaging: vthota23304@direct.myadvocateaurora.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pillar Health RacineRacine, WI, CCN 521054 Federally qualified health center Corporate Director Feb 26, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1134183783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4448 W. LOOMIS RD.",
            "address_2": "STE 100",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204851",
            "telephone_number": "414-281-5150",
            "fax_number": "414-281-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOTA",
        "first_name": "VENKATA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "28604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31484200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4448 W. Loomis Rd.",
            "address_2": "Ste 100",
            "city": "Greenfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532204851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vthota23304@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4448 W. Loomis Rd.",
            "address_2": "Ste 100",
            "city": "Greenfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532204851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.