Ascension Medical Group-Southeast Wisconsin Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC

Practice address

2301 N Lake Dr
Milwaukee, WI 53211-4508

Phone

(414) 585-1000

NPI assigned

Mar 10, 2022

Organization subpart

No

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

Authorized official

Name

David Jirovec

Title

Finance Director

Phone

(715) 347-6655

Specialties & licenses 2

Addresses

Other names 1

• AMG Anesthesia Other name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  O20031104000421

  Same enrollment

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kohldon Carter Boydston, MD

  • Urology Physician
  • Wauwatosa, WI
  • NPI 1518320100
  NPD
• Elizabeth Trudy Camenga, MD

  • Physical Medicine & Rehabilitation Physician
  • Mount Pleasant, WI
  • NPI 1396234787
  NPD
• James Richard Troken, D.O.

  • Cardiovascular Disease Physician
  • Glendale, WI
  • NPI 1538515101
  NPD
• Anuradha R Thopu, MD

  • Pulmonary Disease Physician
  • Douglasville, GA
  • NPI 1982698684
  NPD
• Penny J Williams, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1588649453
  NPD

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1194473066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W RIVER WOODS PKWY",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121060",
            "telephone_number": "414-465-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114508",
            "telephone_number": "414-585-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-10",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "JIROVEC",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "715-347-6655"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMG Anesthesia",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "AMG Anesthesia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Michael Asad, RN
• Kwesi Asantey, MD
• Ascend Community Supports LLC
• Ascending Angels Healthcare Training and Staffing Solutions LLC
• Ascension All Saints Hospital, Inc
• Ascension SE Wisconsin Hospital, Inc
• Ascension SE Wisconsin Hospital, Inc
• Ascension SE Wisconsin Hospital, Inc
• Ascension St Francis Hospital, Inc
• Ascension St Francis Hospital, Inc

• Anesthesiology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Anesthesiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.