NPIMap

Individual provider Active NPI

Chad Glisch

  • Hematology & Oncology Physician
  • West Allis, WI
National Provider Identifier
1134514078
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
66427 Issued in WI
Practice address
8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone
(414) 329-5950
Fax
(414) 329-5943
NPI assigned
Mar 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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 66427 WI
Hematology & Oncology Physician 207RH0003X 66427 WI Primary

Addresses

Primary practice location

8901 W Lincoln Ave
West Allis, WI 53227-2409

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other practice location 1

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6850

Other identifiers 2

IdentifierTypeStateIssuer
100061678MedicaidWI
1134514078MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cglisch383035@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190523002843 WI Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7012293442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Aurora Health Care Metro, Inc.Group PAC ID 8628986536, 75 clinicians

Practice addresses (Care Compare)

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66427WIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Metro, Inc. Hematology & Oncology CurrentSince Sep 23, 2023 Accepting new patients
Aurora Advanced Healthcare, Inc. Internal Medicine CurrentSince Sep 23, 2023 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Sep 23, 2023 Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

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

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1055 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 476-8450

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

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: cglisch383035@direct.myadvocateaurora.org

Organizations & group practices 4

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 6

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1134514078",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272409",
            "telephone_number": "414-329-5950",
            "fax_number": "414-329-5943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-6850",
            "fax_number": "414-805-6851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLISCH",
        "first_name": "CHAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "66427",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "66427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100061678",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134514078",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cglisch383035@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8901 W Lincoln Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "8901 W Lincoln Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.