Individual provider Active NPI

Stephanie Anne Momper, MD

  • Internal Medicine Physician
  • Germantown, WI
National Provider Identifier
1194899005
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50349 Issued in WI
Practice address
N112W15415 Mequon Rd
Germantown, WI 53022-3410
Phone
(262) 250-7800
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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 50349 WI Primary
Pediatrics Physician 208000000X 50349 WI

Addresses

Primary practice location

N112W15415 Mequon Rd
Germantown, WI 53022-3410

Mailing address

4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (262) 250-7800

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
I20090828000147 WI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4789739681 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Medical College of Wisconsin, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

N112W15415 Mequon Rd
Germantown, WI 53022-3410
Phone (262) 250-7800

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50349WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Sep 7, 2010 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Feb 1, 2023 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Sep 7, 2010 Accepting new patients
Wisconsin Health Fund CurrentSince Oct 20, 2012 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Current Accepting new patients

Locations

19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000

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

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

2061 Cheyenne Ct
Grafton, WI 53024
Phone (262) 243-4952

6200 W Bluemound Rd
Milwaukee, WI 53213
Phone (414) 479-3668

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1194899005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "262-250-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N112W15415 MEQUON RD",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223410",
            "telephone_number": "262-250-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMPER",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "50349",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "50349",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

Verify at the official NPI Registry.