Individual provider Active NPI

Daniel Mielnicki, M.D.

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1366407272
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
53510 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-6450
Fax
(414) 805-6464
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 53510 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Department of Emergency Medicine
Milwaukee, WI 53226-3522
Phone (414) 805-6450

Other practice location 1

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone (262) 253-5400

Other practice location 2

11421 N Port Washington Road
Mequon, WI 53092-0990
Phone (414) 955-6450

Other practice location 3

1155 N Mayfair Rd
Milwaukee, WI 53226-3462
Phone (414) 955-5990

Other practice location 4

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7200

Other practice location 5

7901 S 6th St
Oak Creek, WI 53154-2010
Phone (414) 346-8000

Other identifiers 2

IdentifierTypeStateIssuer
1366407272MedicaidVA
1366407272MedicaidWI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091103000716 WI Practitioner - Emergency Medicine 7911093711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53510WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2013 Accepting new patients
The Medical College of Wisconsin, Inc. Emergency Medicine CurrentSince Oct 1, 2009 Accepting new patients
Riverside Physician Services, Inc. Emergency Medicine Past Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

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

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

11421 N Port Washington Rd
Mequon, WI 53092
Phone (262) 518-4910

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

4805 S Moorland Rd
New Berlin, WI 53151
Phone (262) 798-7200

7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

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

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • Direct secure messaging: dmielnickimd33349@direct.froedtert.com

Organizations & group practices 5

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1366407272",
    "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",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W129N7055 Northfield Dr",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530510538",
            "country_code": "US",
            "telephone_number": "262-253-5400",
            "fax_number": "262-253-3399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11421 N Port Washington Road",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530920990",
            "country_code": "US",
            "telephone_number": "414-955-6450",
            "fax_number": "414-955-0082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 N Mayfair Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263462",
            "country_code": "US",
            "telephone_number": "414-955-5990",
            "fax_number": "414-955-6282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4805 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517401",
            "country_code": "US",
            "telephone_number": "262-798-7200",
            "fax_number": "262-798-7201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531542010",
            "country_code": "US",
            "telephone_number": "414-346-8000",
            "fax_number": "414-346-8010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIELNICKI",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "53510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366407272",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366407272",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.