Active NPI
Mario Riccardo Colella, D.O.
- Emergency Medicine Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 50358
- Practice address
- 9200 W Wisconsin Ave
Department of Emergency Medicine
Milwaukee, WI 53226-3522 - Phone
- (414) 805-6450
- Fax
- (414) 805-6464
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | H0060361 | MD | |
| Emergency Medicine Physician | 207P00000X | 50358 | WI | Primary |
Addresses
Primary practice location
9200 W Wisconsin Ave
Department of Emergency Medicine
Milwaukee, WI 53226-3522
Mailing address
9200 W Wisconsin Ave
Department of Emergency Medicine
Milwaukee, WI 53226-3522
Phone (414) 805-6450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336106277 | Medicaid | WI |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50358 | WI | MD | Emergency Medicine Physician |
| H0060361 | MD | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Emergency Medicine | Current | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Johns Hopkins Emergency Medical | Past | Accepting new patients |
Locations
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
Interoperability endpoints
- mcolellado13250@direct.froedtert.com
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Emergency Medicine
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
-
- Emergency Care Clinic/Center
- Columbia, MD
- NPI 1922098466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362614400000",
"number": "1336106277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-6450",
"fax_number": "414-805-6464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-6450",
"fax_number": "414-805-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLELLA",
"first_name": "MARIO",
"middle_name": "RICCARDO",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2013-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "MD",
"license": "H0060361",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "50358",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336106277",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.