Individual provider Active NPI

James Michael Wilson, M.D.

  • Anesthesiology Physician
  • Milwaukee, WI
National Provider Identifier
1255315271
Registry record updated Feb 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
45183-020 Issued in WI
Practice address
2025 E Newport Ave
Milwaukee, WI 53211-2906
Phone
(414) 961-3300
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2009

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 45183-020 WI Primary

Addresses

Primary practice location

2025 E Newport Ave
Milwaukee, WI 53211-2906

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
34337800MedicaidWI
P00384887OtherRAIL ROAD 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
I20040310000101 WI Practitioner - Anesthesiology 9335037498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tulane University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners Services SCGroup PAC ID 4082832514, 37 clinicians

Practice addresses (Care Compare)

2801 W Kinnickinnic River Pkwy
Suite 1080
Milwaukee, WI 53215-3689
Phone (414) 908-6500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45183-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Partners Services, S.C. Anesthesiology CurrentSince Nov 1, 2017 Accepting new patients
Metropolitan Watertown LLC Anesthesiology Past Accepting new patients

Locations

88948 Box
Milwaukee, WI 53288

2801 W Kinnickinnic River Pkwy
Ste 1080
Milwaukee, WI 53215
Phone (414) 908-6506

1111 Delafield St
Ste 322
Waukesha, WI 53188
Phone (262) 650-7322

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234656000000",
    "number": "1255315271",
    "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": "2025 E NEWPORT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532112906",
            "telephone_number": "414-961-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2009-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "45183-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34337800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00384887",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.