Individual provider Active NPI

Nicholas Robert Julga, PA-C

  • Surgical Physician Assistant
  • Wauwatosa, WI
National Provider Identifier
1174505333
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
851-023 Issued in WI
Practice address
3077 N Mayfair Rd Ste 305
Wauwatosa, WI 53222-4305
Phone
(414) 384-6700
Fax
(414) 727-1058
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 851-023 WI Primary

Addresses

Primary practice location

3077 N Mayfair Rd Ste 305
Wauwatosa, WI 53222-4305

Mailing address

3077 N Mayfair Rd Ste 305
Wauwatosa, WI 53222-4305
Phone (414) 384-6700

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101104000807 WI Practitioner - Physician Assistant 8224222104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
73.65
Promoting interoperability
87
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
851WIMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Aug 8, 2011 Accepting new patients
Integrated Spine Care, S.C. PastSince Aug 1, 1998 Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

2500 W Layton Ave
Ste 160
Milwaukee, WI 53221
Phone (414) 389-3023

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

3077 N Mayfair Rd
Ste 305
Wauwatosa, WI 53222
Phone (414) 258-3500

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.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1174505333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 N MAYFAIR RD STE 305",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224305",
            "telephone_number": "414-384-6700",
            "fax_number": "414-727-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 N MAYFAIR RD STE 305",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224305",
            "telephone_number": "414-384-6700",
            "fax_number": "414-727-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JULGA",
        "first_name": "NICHOLAS",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "851-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.