NPIMap

Kieran McAvoy, MD

Individual provider Active NPI Internal Medicine Physician · Waukesha, WI

NPI 1316407372 · NPPES record last updated Aug 22, 2023

Key facts

NPI
1316407372
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
74696-20 (WI)
Practice address
N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone
(262) 875-5070
NPI assigned
Mar 24, 2019
Sex
Female
Sole proprietor
No

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Internal Medicine
Also: Geriatric Medicine
Education
Medical College of Wisconsin, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oak Medical SC (118 clinicians)
Maple Medical SC (25 clinicians)

Practice addresses (Care Compare)

18740 W Bluemound Rd
Brookfield, WI 53045-2936
Phone (262) 782-0230

N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone (262) 875-5070

Hospital & facility affiliations

  • Commonheart Home Health Home health agency · Waukesha, WI · CCN 527151
  • Preceptor Home Health Home health agency · Germantown, WI · CCN 527313
  • Commonheart Hospice Hospice · Waukesha, WI · CCN 521578
  • Allay Hospice Hospice · Brookfield, WI · CCN 521583
  • Azura Palliative Care and Hospice Wi Hospice · Milwaukee, WI · CCN 521626
  • Beloit Regional Hospice Hospice · Beloit, WI · CCN 521525
  • Brighton Hospice Wisconsin Hospice · Brookfield, WI · CCN 521603
  • Waukesha Memorial Hospital Hospital · Waukesha, WI · CCN 520008
  • Oconomowoc Memorial Hospital Hospital · Oconomowoc, WI · CCN 520062
  • Masonic Center for Health & Rehab Inc. Nursing home · Dousman, WI · CCN 525572
  • Avina of Milwaukee Nursing home · Milwaukee, WI · CCN 525523
  • Clement Manor Health Care Center Nursing home · Greenfield, WI · CCN 525327
  • Milwaukee Catholic Home Nursing home · Milwaukee, WI · CCN 525635

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230707002853 WI Practitioner - Internal Medicine
Practitioner - Geriatric Medicine		 0840626123 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Medical SC Internal Medicine Current
since Jun 1, 2023		 Accepting new patients
Timothy G McAvoy MD SC Internal Medicine Current
since Aug 1, 2023		 Accepting new patients
Maple Medical SC Internal Medicine Current
since Jun 1, 2023		 Accepting new patients

Locations

18740 W Bluemound Rd
Brookfield, WI 53045
Phone (262) 782-0230

1751 E Main St
Waukesha, WI 53186
Phone (262) 544-1755

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

Interoperability endpoints

  • Direct secure messaging: kmcavoy59614@direct.phci.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 74696-20 WI
Internal Medicine Physician 207R00000X 74696-20 WI Yes

Addresses

Primary practice location

N20W22961 Watertown Rd
Waukesha, WI 53186-1306

Mailing address

N20W22961 Watertown Rd
Waukesha, WI 53186-1306

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2023.

{
    "created_epoch": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1316407372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306",
            "telephone_number": "262-875-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCAVOY",
        "first_name": "KIERAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-24",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "74696-20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "74696-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

All providers in Waukesha, WI · Internal Medicine Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.