Individual provider Active NPI

Filoreta D Udrea, MD

  • Psychiatry Physician
  • Wauwatosa, WI
National Provider Identifier
1194806141
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
41194-020 Issued in WI
Practice address
1220 Dewey Ave
Wauwatosa, WI 53213-2504
Phone
(414) 454-6600
NPI assigned
Oct 18, 2006
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 41194-020 WI Primary

Addresses

Primary practice location

1220 Dewey Ave
Wauwatosa, WI 53213-2504

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 1

IdentifierTypeStateIssuer
32623200MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address fudrea9401@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20070105000257 WI Practitioner - Psychiatry 5991705535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2424 S 90TH St
West Allis, WI 53227-2455
Phone (414) 328-8630

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41194-020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Northwest Iowa Mental Health Center Past Accepting new patients
Northwest Iowa Mental Health Center Past Accepting new patients

Locations

2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817

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

1220 Dewey Ave
Wauwatosa, WI 53213
Phone (414) 454-6600

2424 S 90th St
West Allis, WI 53227
Phone (414) 321-2255

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, 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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1194806141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 DEWEY AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132504",
            "telephone_number": "414-454-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDREA",
        "first_name": "FILORETA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "41194-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32623200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fudrea9401@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1220 Dewey Ave",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532132504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1220 Dewey Ave",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532132504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.