NPIMap

Organization Active NPI

Accentcare Medical Group of Wisconsin, S.C.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • West Allis, WI
National Provider Identifier
1275976979
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
ACCENTCARE MEDICAL GROUP OF WISCONSIN, S.C.
Practice address
6737 W Washington St
Ste 2150
West Allis, WI 53214-5647
Phone
(800) 379-5105
NPI assigned
Apr 11, 2013
Last updated
Jan 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
Carrie Bill
Title
Finance Director
Phone
(847) 692-1148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X NU Primary

Addresses

Primary practice location

6737 W Washington St
Ste 2150
West Allis, WI 53214-5647

Mailing address

6400 Shafer CT Ste 300a
Rosemont, IL 60018-4914
Phone (847) 692-1000

Other names 1

  • Seasons Medical Group of Wisconsin, SC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130715000500 WI Part B Supplier - Clinic/Group Practice 4284874298 Receives reassigned benefits from 18 practitioners
Practice locations: West Allis, WI

National Provider Directory

National Provider Directory

Locations

6737 W Washington St
Ste 2
West Allis, WI 53214
Phone (414) 203-8310

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1275976979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SHAFER CT STE 300A",
            "city": "ROSEMONT",
            "state": "IL",
            "postal_code": "600184914",
            "telephone_number": "847-692-1000",
            "fax_number": "224-532-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "STE 2150",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532145647",
            "telephone_number": "800-379-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCENTCARE MEDICAL GROUP OF WISCONSIN, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-11",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "BILL",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "847-692-1148"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seasons Medical Group of Wisconsin, SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.