Individual provider Active NPI

Joseph L Shaker, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Menomonee Falls, WI
National Provider Identifier
1164561247
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
28432 Issued in WI
Practice address
W129N7055 Northfield Dr
Community Memorial Medical Commons
Menomonee Falls, WI 53051-0538
Phone
(262) 253-2510
Fax
(262) 253-3399
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X M9870 ID
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 28432 WI Primary

Addresses

Primary practice location

W129N7055 Northfield Dr
Community Memorial Medical Commons
Menomonee Falls, WI 53051-0538

Mailing address

W129N7055 Northfield Dr
Community Memorial Medical Commons
Menomonee Falls, WI 53051-0538
Phone (262) 253-2510

Other practice location 1

11430 N Port Washington Rd
Mequon, WI 53092-3414
Phone (262) 518-1900

Other practice location 2

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6550

Other identifiers 1

IdentifierTypeStateIssuer
1164561247MedicaidWI

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
I20040329001679 WI Practitioner - EndocrinologyPractitioner - Internal Medicine 4183516487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Georgetown University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone (262) 253-5400

Hospital & facility affiliations

  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177
  • St Josephs Community Hospital West Bend Hospital, West Bend, WI, CCN 520063
  • Community Memorial Hospital Hospital, Menomonee Falls, WI, CCN 520103
  • Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107
  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9870IDMDEndocrinology, Diabetes & Metabolism Physician
28432WIMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2016 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2016 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

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

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

11430 N Port Washington Rd
Mequon, WI 53092
Phone (262) 518-1900

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

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

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

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

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

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

Interoperability endpoints

  • Direct secure messaging: jshakermd5610@direct.froedtert.com

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 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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1164561247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W129N7055 NORTHFIELD DR",
            "address_2": "COMMUNITY MEMORIAL MEDICAL COMMONS",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510538",
            "telephone_number": "262-253-2510",
            "fax_number": "262-253-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W129N7055 NORTHFIELD DR",
            "address_2": "COMMUNITY MEMORIAL MEDICAL COMMONS",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510538",
            "telephone_number": "262-253-2510",
            "fax_number": "262-253-3399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11430 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923414",
            "country_code": "US",
            "telephone_number": "262-518-1900",
            "fax_number": "262-518-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-6550",
            "fax_number": "414-456-6210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAKER",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "ID",
            "license": "M9870",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "28432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164561247",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.