Individual provider Active NPI

Brenna Marie Tomczak, MD

  • Emergency Medicine Physician
  • Wauwatosa, WI
National Provider Identifier
1417418047
Registry record updated Mar 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
75819-20 Issued in WI
Practice address
10625 W North Ave Ste 101B
Wauwatosa, WI 53226-2315
Phone
(414) 877-5350
Fax
(414) 877-5360
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 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 75819-20 WI Primary

Addresses

Primary practice location

10625 W North Ave Ste 101B
Wauwatosa, WI 53226-2315

Mailing address

10625 W North Ave Ste 101B
Wauwatosa, WI 53226-2315
Phone (414) 877-5350

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
I20221010000300 WI Practitioner - Emergency Medicine 3577992643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

10101 S 27TH St
Franklin, WI 53132-7209
Phone (414) 325-4700

19333 W N Ave
Brookfield, WI 53045-4132
Phone (262) 785-2000

3237 S 16TH St
Milwaukee, WI 53215-4526
Phone (414) 647-5000

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000

Hospital & facility affiliations

  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • Ascension Wisconsin Hosp Menomonee Falls Campus Hospital, Menomonee Falls, WI, CCN 520214
  • Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078
  • Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75819-20WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
EMS Observation, S.C. Emergency Medicine CurrentSince Mar 19, 2023 Accepting new patients

Locations

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932

10625 W North Ave
Ste 101B
Wauwatosa, WI 53226
Phone (414) 727-9183

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 and National Provider Directory roles.

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678579200000",
    "number": "1417418047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 101B",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350",
            "fax_number": "414-877-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 101B",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350",
            "fax_number": "414-877-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCZAK",
        "first_name": "BRENNA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-03-12",
        "certification_date": "2023-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "75819-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.