Individual provider Active NPI

Ethan Wasson, MD

  • Anesthesiology Physician
  • Milwaukee, WI
National Provider Identifier
1285166835
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35.142321 Issued in OH
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-6100
NPI assigned
Apr 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 35.142321 OH Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250501002523 NY Practitioner - Anesthesiology 0345578878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Care of Long Island PLLCGroup PAC ID 7517042211, 175 clinicians
Schenectady Anesthesia Associates, P.C.Group PAC ID 5294628087, 43 clinicians

Practice addresses (Care Compare)

1375 Washington Ave
Suite 101
Albany, NY 12206-1056
Phone (518) 533-5000

16 Maxwell Dr
Clifton Park, NY 12065-2920
Phone (518) 489-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.67 of 100Reported as group
Quality
74.91
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Care of Long Island PLLC CurrentSince Jul 28, 2025 Accepting new patients
Schenectady Anesthesia Associates, P.C. Anesthesiology CurrentSince Jun 1, 2025 Accepting new patients
Nyc Medical of Queens PC PastSince Mar 9, 2020 Accepting new patients

Locations

1375 Washington Ave
Ste 101
Albany, NY 12206
Phone (518) 438-4483

16 Maxwell Dr
Clifton Park, NY 12065
Phone (518) 557-1800

1785 Route 9
Ste 101
Halfmoon, NY 12065
Phone (518) 533-1269

7916 37th Ave
Jackson Heights, NY 11372
Phone (212) 927-0013

187 Veterans Blvd
Massapequa, NY 11758
Phone (516) 795-5523

1201 Nott St
Ste 106
Schenectady, NY 12308
Phone (518) 374-3123

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAEACD

Organizations & group practices 3

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 1

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1285166835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSON",
        "first_name": "ETHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.142321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.