Individual provider Active NPI

Molly Wirth

  • Family Nurse Practitioner
  • Brookfield, WI
National Provider Identifier
1326812546
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1087492 Issued in WI
Practice address
1350 S Sunny Slope Rd
Brookfield, WI 53005-7060
Phone
(262) 798-8750
NPI assigned
Nov 8, 2023
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1087492 WI Primary

Addresses

Primary practice location

1350 S Sunny Slope Rd
Brookfield, WI 53005-7060

Mailing address

1350 S Sunny Slope Rd
Brookfield, WI 53005-7060
Phone (262) 798-8750

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240405002261 WI Practitioner - Nurse Practitioner 0345688578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1350 S Sunny Slope Rd
Brookfield, WI 53005-7060
Phone (414) 805-9600

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1087492WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 8, 2024 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 8, 2024 Accepting new patients

Locations

1350 S Sunny Slope Rd
Brookfield, WI 53005
Phone (262) 798-8750

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Interoperability endpoints

  • Direct secure messaging: mwirth809285@direct.froedtert.com

Organizations & group practices 2

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 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": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1326812546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S SUNNY SLOPE RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530057060",
            "telephone_number": "262-798-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S SUNNY SLOPE RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530057060",
            "telephone_number": "262-798-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "MOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-07-01",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "1087492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.