Individual provider Active NPI

Andra Kay Cicero, D.O.

  • Obstetrics & Gynecology Physician
  • Milwaukee, WI
National Provider Identifier
1275789752
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
60273-21 Issued in WI
Practice address
945 N 12TH St
Milwaukee, WI 53233-1305
Phone
(414) 219-5800
NPI assigned
Aug 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036127667 IL
Obstetrics & Gynecology Physician 207V00000X 60273-21 WI Primary

Addresses

Primary practice location

945 N 12TH St
Milwaukee, WI 53233-1305

Mailing address

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-5800

Other identifiers 1

IdentifierTypeStateIssuer
100029376MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address acicero81533@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20130626000130 WI Practitioner - Obstetrics/Gynecology 6608044813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2007
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)

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

Hospital & facility affiliations

  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036127667ILMDObstetrics & Gynecology Physician
60273-21WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Obstetrics & Gynecology Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince May 6, 2013 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince May 6, 2013 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

1218 W Kilbourn Ave
Ste 203
Milwaukee, WI 53233

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

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

8905 W Lincoln Ave
Ste 515
West Allis, WI 53227
Phone (414) 328-8650

Interoperability endpoints

  • Direct secure messaging: acicero81533@direct.myadvocateaurora.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1275789752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICERO",
        "first_name": "ANDRA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036127667",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "60273-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100029376",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acicero81533@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "945 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "945 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.