Individual provider Active NPI

John K Hur, M.D.

  • Anesthesiology Physician
  • Brookfield, WI
National Provider Identifier
1255314076
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
36104-020 Issued in WI
Practice address
19333 W North Ave
Brookfield, WI 53045-4132
Phone
(262) 785-2000
NPI assigned
Nov 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 36104-020 WI Primary

Addresses

Primary practice location

19333 W North Ave
Brookfield, WI 53045-4132

Mailing address

225 S Executive Dr
Brookfield, WI 53005-4266
Phone (262) 787-4026

Other identifiers 3

IdentifierTypeStateIssuer
32552600MedicaidWI
P00372269OtherRAIL ROAD MEDICARE
P01504458OtherWIRR MEDICARE

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
I20041208000148 WI Practitioner - Anesthesiology 5193797405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Anesthesia and Pain Specialists SCGroup PAC ID 2365598406, 11 clinicians

Practice addresses (Care Compare)

10101 S 27TH St
Franklin, WI 53132-7209
Phone (414) 817-5800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36104-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Anesthesia and Pain Specialists SC Anesthesiology CurrentSince Jan 1, 2014 Accepting new patients
Glendale Anesthesia Associates Anesthesiology Past Accepting new patients
Chad Novasic PT LTD Past Accepting new patients

Locations

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

Organizations & group practices 3

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 1

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": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1255314076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S EXECUTIVE DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054266",
            "telephone_number": "262-787-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19333 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454132",
            "telephone_number": "262-785-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUR",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "36104-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32552600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00372269",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01504458",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.