Individual provider Active NPI

Stella M Mahaga, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenfield, WI
National Provider Identifier
1255598140
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7261-33 Issued in WI
Practice address
8777 W Forest Home Ave
Greenfield, WI 53228-3421
Phone
(262) 292-4777
Fax
(262) 518-7052
NPI assigned
May 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7261-33 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7261-33 WI Primary

Addresses

Primary practice location

8777 W Forest Home Ave
Greenfield, WI 53228-3421

Mailing address

8777 W Forest Home Ave
Greenfield, WI 53228-3421
Phone (262) 292-4777

Other identifiers 1

IdentifierTypeStateIssuer
1255598140MedicaidWI

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161102001020 WI Practitioner - Nurse Practitioner 4284912858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington County WisconsinGroup PAC ID 1951202142, 10 clinicians

Practice addresses (Care Compare)

333 E Washington St
Suite 2100
West Bend, WI 53095-2503
Phone (262) 335-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7261-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Wisconsin CurrentSince Jan 30, 2025 Accepting new patients

Locations

333 E Washington St
Ste 2100
West Bend, WI 53095
Phone (262) 335-4545

Organizations & group practices 1

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1255598140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8777 W FOREST HOME AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283421",
            "telephone_number": "262-292-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8777 W FOREST HOME AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283421",
            "telephone_number": "262-292-4777",
            "fax_number": "262-518-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAGA",
        "first_name": "STELLA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7261-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "7261-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255598140",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.