Individual provider Active NPI

Mary Conti Swiontoniowski, M.D.

  • Hospitalist Physician
  • Waukesha, WI
National Provider Identifier
1174596811
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
46391-020 Issued in WI
Practice address
725 American Avenue
Room 2036
Waukesha, WI 53188
Phone
(262) 928-5400
Fax
(262) 928-6140
NPI assigned
Feb 13, 2006
Last updated
Nov 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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 46391 WI
Hospitalist Physician 208M00000X 46391-020 WI Primary

Addresses

Primary practice location

725 American Avenue
Room 2036
Waukesha, WI 53188

Mailing address

N17W24100 Riverwood Dr
Prohealth Care Medical Associates Inc.
Waukesha, WI 53188-1177
Phone (262) 928-4100

Other identifiers 1

IdentifierTypeStateIssuer
34465900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46391WIMDInternal Medicine Physician
46391-020WIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Suburban Medical Center Internal Medicine Past Accepting new patients
Prohealth Medical Group Inc Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1174596811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N17W24100 RIVERWOOD DR",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881177",
            "telephone_number": "262-928-4100",
            "fax_number": "262-928-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVENUE",
            "address_2": "ROOM 2036",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-928-5400",
            "fax_number": "262-928-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIONTONIOWSKI",
        "first_name": "MARY",
        "middle_name": "CONTI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "46391",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "46391-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34465900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.