Individual provider Active NPI

Hanadi Bu-Ali, M.D.

  • Surgery Physician
  • Wauwatosa, WI
National Provider Identifier
1316069776
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
51735-020 Issued in WI
Practice address
201 N Mayfair Rd
3Rd Floor
Wauwatosa, WI 53226-4216
Phone
(414) 256-1920
Fax
(414) 256-1921
NPI assigned
Apr 5, 2007
Last updated
Aug 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301078926 MI
Surgery Physician 208600000X 35 . 089507 OH
Surgery Physician 208600000X 51735-020 WI Primary

Addresses

Primary practice location

201 N Mayfair Rd
3Rd Floor
Wauwatosa, WI 53226-4216

Mailing address

201 N Mayfair Rd
3Rd Floor
Wauwatosa, WI 53226-4216
Phone (414) 256-1920

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
I20080721000200 WI Practitioner - General Surgery 1153494463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19333 W N Ave
Brookfield, WI 53045-4132
Phone (262) 780-4111

201 N Mayfair Rd
Wauwatosa, WI 53226-4216

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301078926MIMDSurgery Physician
35 . 089507OHMDSurgery Physician
51735-020WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Aug 1, 2008 Accepting new patients
The Medical College of Wisconsin, Inc. Surgery CurrentSince Sep 5, 2013 Accepting new patients
Ascension All Saints Hospital, Inc Past Accepting new patients
Ascension SE Wisconsin Hospital, Inc Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

201 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 259-7200

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

201 N Mayfair Rd
Fl 3
Wauwatosa, WI 53226
Phone (414) 259-7480

201 N Mayfair Rd
Ste 315
Wauwatosa, WI 53226
Phone (414) 259-7200

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1316069776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "address_2": "3RD FLOOR",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-256-1920",
            "fax_number": "414-256-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "address_2": "3RD FLOOR",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-256-1920",
            "fax_number": "414-256-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BU-ALI",
        "first_name": "HANADI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-05",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301078926",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35 . 089507",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "51735-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.