Individual provider Active NPI

Rafath Ullah, M.D.

  • Interventional Cardiology Physician
  • Kenosha, WI
National Provider Identifier
1326350034
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
61188 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 948-6630
NPI assigned
Jul 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 72485 AZ
Cardiovascular Disease Physician 207RC0000X 61188 WI
Interventional Cardiology Physician 207RI0011X 61188 WI Primary
Cardiovascular Disease Physician 207RC0000X 75910 MN
Internal Medicine Physician 207R00000X 61188 WI
Internal Medicine Physician 207R00000X 125.058933 IL
Cardiovascular Disease Physician 207RC0000X 036131820 IL

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

Other practice location 2

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6000

Other practice location 3

3333 Green Bay Rd
North Chicago, IL 60064-3095
Phone (847) 578-3227

Other practice location 4

333 E 2nd St
Richland Center, WI 53581-1914
Phone (608) 647-6321

Other identifiers 1

IdentifierTypeStateIssuer
100033626MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address rullah91914@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130621000348 IL Practitioner - Internal Medicine 8224277330 Reassigns benefits to 2 organizations
I20140424000955 WI Practitioner - Internal Medicine 8224277330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Amg Illinois LTDGroup PAC ID 8527117027, 24 clinicians

Practice addresses (Care Compare)

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

45 Tower CT
Gurnee, IL 60031-3376
Phone (847) 623-3200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting18
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.058933ILMDInternal Medicine Physician
61188WIMDInternal Medicine Physician
036131820ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amg Illinois LTD Internal Medicine CurrentSince May 1, 2024 Accepting new patients
Stat Cardiologist Inc Cardiovascular Disease CurrentSince May 1, 2023 Accepting new patients
Amg Illinois LTD CurrentSince May 1, 2024 Accepting new patients
Aurora Medical Group, Inc. Internal Medicine Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

45 Tower Ct
Gurnee, IL 60031
Phone (847) 623-3200

1875 W Dempster St
Ste 605
Park Ridge, IL 60068
Phone (847) 439-8780

1345 Wiley Rd
Ste 111
Schaumburg, IL 60173
Phone (630) 451-9694

942 E Roosevelt Rd
West Chicago, IL 60185
Phone (630) 415-2009

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

13250 Washington Ave
Mount Pleasant, WI 53177
Phone (262) 799-8330

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

Interoperability endpoints

  • Direct secure messaging: rullah91914@direct.myadvocateaurora.org
  • Direct secure messaging: rafath.ullah.1@17122.direct.athenahealth.com

Organizations & group practices 6

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 6

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": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1326350034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-6630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36500 Aurora Dr",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "WI",
            "postal_code": "530664899",
            "country_code": "US",
            "telephone_number": "262-434-5000",
            "fax_number": "262-434-4350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154330",
            "country_code": "US",
            "telephone_number": "414-649-6000",
            "fax_number": "414-649-5296",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "North Chicago",
            "state": "IL",
            "postal_code": "600643095",
            "country_code": "US",
            "telephone_number": "847-578-3227",
            "fax_number": "847-578-8647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Richland Center",
            "state": "WI",
            "postal_code": "535811914",
            "country_code": "US",
            "telephone_number": "608-647-6321",
            "fax_number": "866-368-6349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULLAH",
        "first_name": "RAFATH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-10",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "72485",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "61188",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "61188",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "75910",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "61188",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.058933",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036131820",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100033626",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rullah91914@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.