NPIMap

Individual provider Active NPI

Andy Kieu, D.O

  • Clinical Cardiac Electrophysiology Physician
  • Milwaukee, WI
National Provider Identifier
1215355730
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
64854 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone
(414) 649-3390
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 64854 WI
Cardiovascular Disease Physician 207RC0000X 64854 WI
Clinical Cardiac Electrophysiology Physician 207RC0001X 64854 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
100049511MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address akieu188061@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180307000825 WI Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Emergency Medicine 1658650023 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

6901 W Edgerton Ave
Milwaukee, WI 53220-4420
Phone (414) 421-8400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64854WIMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Apr 15, 2018 Accepting new patients
Aurora Advanced Healthcare, Inc. Internal Medicine CurrentSince Apr 15, 2018 Accepting new patients
Aurora Medical Group, Inc. Internal Medicine Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 15, 2018 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Apr 15, 2018 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 15, 2018 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

146 E Geneva Sq
Ste G
Lake Geneva, WI 53147

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111

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

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

2801 W Kinnickinnic River Pkwy
Ste 550
Milwaukee, WI 53215
Phone (414) 385-8780

6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: akieu188061@direct.myadvocateaurora.org

Organizations & group practices 7

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 7

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1215355730",
    "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": "2801 W KINNICKINNIC RIVER PKWY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-649-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEU",
        "first_name": "ANDY",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "64854",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "64854",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WI",
            "license": "64854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100049511",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6901 W EDGERTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532204420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akieu188061@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6901 W EDGERTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532204420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.