Individual provider Active NPI

Peter A Henry, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Milwaukee, WI
National Provider Identifier
1205883766
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
227795 Issued in MA
Practice address
111 E Wisconsin Ave
Suite 2100
Milwaukee, WI 53202-4815
Phone
(414) 290-6700
NPI assigned
May 30, 2006
Last updated
Oct 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 227795 MA Primary
Emergency Medicine Physician 207P00000X 51947-20 WI
Emergency Medicine Physician 207P00000X 036113654 IL

Addresses

Primary practice location

111 E Wisconsin Ave
Suite 2100
Milwaukee, WI 53202-4815

Mailing address

111 E Wisconsin Ave
Suite 2100
Milwaukee, WI 53202-4815
Phone (414) 290-6700

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
I20080910000411 WI Practitioner - Emergency Medicine 8921020264 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ermed, SCGroup PAC ID 5092608554, 45 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6588

3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 828-2530

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227795MAMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Milwaukee Radiologists LTD Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Past Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

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

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

3400 Union Ave
Sheboygan, WI 53081
Phone (920) 802-2100

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baird TrustBrookfield, WI, CCN 525700 Skilled nursing facility Corporate Director
Managing Control - Governing Body
Nov 1, 2021
Nov 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1205883766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE",
            "address_2": "SUITE 2100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024815",
            "telephone_number": "414-290-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE",
            "address_2": "SUITE 2100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024815",
            "telephone_number": "414-290-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "PETER",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MA",
            "license": "227795",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "51947-20",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036113654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.