Individual provider Active NPI

Elton Mustafaraj, D.O.

  • Neuroradiology Physician
  • Burlington, WI
National Provider Identifier
1396009072
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
66935-21 Issued in WI
Practice address
252 McHenry St
Burlington, WI 53105-1828
Phone
(262) 767-6000
NPI assigned
Jun 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 66935-21 WI
Neuroradiology Physician 2085N0700X 66935-21 WI Primary

Addresses

Primary practice location

252 McHenry St
Burlington, WI 53105-1828

Mailing address

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

Other practice location 1

10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078
Phone (262) 292-3151

Other identifiers 1

IdentifierTypeStateIssuer
100068699MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address emustafararj418517@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TN, IL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180611000813 WI Practitioner - Diagnostic Radiology 6901127851 Reassigns benefits to 8 organizations
I20210421000355 TN Practitioner - Diagnostic Radiology 6901127851 Reassigns benefits to 1 organization
I20240715001594 IL Practitioner - Diagnostic Radiology 6901127851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

W231 N1440 Corporate Court
Waukesha, WI 53186-1303
Phone (262) 896-6070

W231N1440 Corporate CT
Waukesha, WI 53186-1303
Phone (262) 896-6000

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Aurora Lakeland Medical Center Hospital, Elkhorn, WI, CCN 520102
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3802TNMDOptometrist
66935-21WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince Feb 1, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Feb 1, 2025 Accepting new patients
Wisconsin Radiology Specialists, S C CurrentSince Oct 1, 2019 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Sep 10, 2019 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Feb 1, 2025 Accepting new patients
Aurora Medical Group, Inc. Internal Medicine Current Accepting new patients
Aurora Advanced Healthcare, Inc. Internal Medicine CurrentSince Feb 1, 2025 Accepting new patients
Premier Radiology Wisconsin, LLC Diagnostic Radiology CurrentSince Mar 28, 2020 Accepting new patients
Precision Radiology - Illinois LTD CurrentSince Feb 1, 2023 Accepting new patients
Middle Tennessee Imaging LLC Diagnostic Radiology CurrentSince Apr 5, 2021 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Sep 10, 2019 Accepting new patients
Sacred Heart Rehabilitation Institute, Inc. PastSince Jun 21, 2022 Accepting new patients

Locations

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

28 White Bridge Pike
Ste 111
Nashville, TN 37205
Phone (615) 986-6153

252 McHenry St
Burlington, WI 53105
Phone (262) 763-2411

3111 W Rawson Ave
Franklin, WI 53132
Phone (414) 325-4300

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

13133 N Port Washington Rd
Ste 226
Mequon, WI 53097
Phone (262) 243-3660

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

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

2311 N Prospect Ave
Milwaukee, WI 53211
Phone (414) 319-3000

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

1703 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 457-4438

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

10945 N Port Washington Rd
Ste 201
Thiensville, WI 53092
Phone (262) 478-0301

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • Direct secure messaging: emustafararj418517@direct.myadvocateaurora.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 7

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1396009072",
    "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": "252 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051828",
            "telephone_number": "262-767-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10945 N Port Washington Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530925078",
            "country_code": "US",
            "telephone_number": "262-292-3151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSTAFARAJ",
        "first_name": "ELTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "66935-21",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WI",
            "license": "66935-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100068699",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emustafararj418517@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "252 McHenry St",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531051828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "252 McHenry St",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531051828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

Verify at the official NPI Registry.