Active NPI
Steven J Mamerow, M.D.
- Internal Medicine Physician
- Muskego, WI
National Provider Identifier
1194798025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 22448
- Practice address
- S69 W15636 Janesville Road
Prohealth Care Medical Associates, Inc
Muskego, WI 53150-7900 - Phone
- (262) 928-7000
- Fax
- (414) 422-2075
- NPI assigned
- Feb 10, 2006
- Last updated
- Oct 13, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 22448 | WI | Primary |
Addresses
Primary practice location
S69 W15636 Janesville Road
Prohealth Care Medical Associates, Inc
Muskego, WI 53150-7900
Mailing address
N17 W24100 Riverwood Drive
Prohealth Care Medical Associates, Inc.
Waukesha, WI 53188-1177
Phone (262) 928-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30380700 | Medicaid | WI |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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": "1139529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1194798025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N17 W24100 RIVERWOOD DRIVE",
"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": "S69 W15636 JANESVILLE ROAD",
"address_2": "PROHEALTH CARE MEDICAL ASSOCIATES, INC",
"city": "MUSKEGO",
"state": "WI",
"postal_code": "531507900",
"telephone_number": "262-928-7000",
"fax_number": "414-422-2075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMEROW",
"first_name": "STEVEN",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-10",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "22448",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30380700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskego, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.