Individual provider Active NPI

Monica B Musete, MD

  • Pediatrics Physician
  • Milwaukee, WI
National Provider Identifier
1275897019
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61077-20 Issued in WI
Practice address
3201 S 16TH St Ste 1020
Milwaukee, WI 53215-4532
Phone
(414) 643-7337
Fax
(920) 563-7705
NPI assigned
Jun 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 61077-20 WI Primary
Pediatrics Physician 208000000X 2012020346 MO

Addresses

Primary practice location

3201 S 16TH St Ste 1020
Milwaukee, WI 53215-4532

Mailing address

3201 S 16TH St Ste 1020
Milwaukee, WI 53215-4532
Phone (414) 643-7337

Other identifiers 3

IdentifierTypeStateIssuer
431560263OtherMOTRICARE
P01085141OtherMOMCR RR
193620001MedicaidAR

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
I20140130000608 WI Practitioner - Pediatric Medicine 7113173832 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61077-20WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Pediatrics LLC Pediatrics Current Accepting new patients
Samir Mullick MD SC Pediatrics CurrentSince Oct 14, 2013 Accepting new patients
St Francs Pediatrics Pediatrics Current Accepting new patients
Fort Healthcare Inc CurrentSince Jul 1, 2018 Accepting new patients
Fort Healthcare Inc CurrentSince Jul 1, 2018 Accepting new patients

Locations

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

500 McMillen St
Fort Atkinson, WI 53538
Phone (920) 563-5571

3440 S 27th St
Milwaukee, WI 53215
Phone (414) 384-2900

3201 S 16th St
Ste 1020
Milwaukee, WI 53215
Phone (414) 643-7337

4267 W Fond du Lac Ave
Milwaukee, WI 53216
Phone (414) 873-3440

3201 S 16th St
Ste 100
Milwaukee, WI 53215
Phone (414) 647-5203

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/

Organizations & group practices 5

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1275897019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 S 16TH ST STE 1020",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154532",
            "telephone_number": "414-643-7337",
            "fax_number": "414-643-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S 16TH ST STE 1020",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154532",
            "telephone_number": "414-643-7337",
            "fax_number": "920-563-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSETE",
        "first_name": "MONICA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "61077-20",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2012020346",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RR",
            "identifier": "P01085141",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193620001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.