Individual provider Active NPI

Felix De Clercq, CAA

  • Anesthesiologist Assistant
  • Milwaukee, WI
National Provider Identifier
1356883979
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
505 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-8700
Fax
(414) 259-1522
NPI assigned
Nov 14, 2016
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 505 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171102001440 MO Practitioner - Anesthesiology Assistant 7315203650 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Anesthesia Providers SCGroup PAC ID 9830480581, 180 clinicians

Practice addresses (Care Compare)

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Anesthesiologist Assistant CurrentSince Apr 15, 2019 Accepting new patients
Orthomed Staffing LLC CurrentSince Jun 29, 2023 Accepting new patients

Locations

305 N Keene St
Ste 107
Columbia, MO 65201
Phone (573) 239-3310

211 NE 54th St
Ste 100
Kansas City, MO 64118
Phone (816) 455-4214

200 NE 54th St
Unit 200
Kansas City, MO 64118

315 S Osteopathy Ave
Kirksville, MO 63501
Phone (660) 785-1000

4150 N Mulberry Dr
Ste 100
North Kansas City, MO 64116
Phone (816) 214-4364

1040 Old des Peres Rd
Saint Louis, MO 63131
Phone (314) 729-9780

10435 Clayton Rd
Ste 110
Saint Louis, MO 63131
Phone (314) 576-1400

4594 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 842-2607

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

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 2

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": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1356883979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8700",
            "fax_number": "414-259-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8700",
            "fax_number": "414-259-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CLERCQ",
        "first_name": "FELIX",
        "name_prefix": "Mr.",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-14",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "WI",
            "license": "505",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.