Individual provider Active NPI

Mark T. Wichman, M.D.

  • Orthopaedic Surgery Physician
  • Wauwatosa, WI
National Provider Identifier
1437136488
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
37933 Issued in WI
Practice address
2999 N Mayfair Rd
Wauwatosa, WI 53222-4306
Phone
(414) 479-7000
NPI assigned
Dec 29, 2005
Last updated
Jul 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 37933 WI
Orthopaedic Surgery Physician 207X00000X 37933 WI Primary

Addresses

Primary practice location

2999 N Mayfair Rd
Wauwatosa, WI 53222-4306

Mailing address

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

Other practice location 1

1575 N Rivercenter Dr
Suite 160
Milwaukee, WI 53212-3978
Phone (414) 274-7220

Other identifiers 2

IdentifierTypeStateIssuer
P00682036OtherWIRR MEDICARE
32253100MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mwichman716@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
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
I20090115000687 WI Practitioner - Orthopedic Surgery 8022171123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Wisconsin School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

14555 W National Ave
Suite 120
New Berlin, WI 53151-4494
Phone (262) 827-2955

2424 S 90TH St
Suite 306
West Allis, WI 53227-2455
Phone (414) 328-8750

2999 N Mayfair Rd
Suite 100
Wauwatosa, WI 53222-4306
Phone (414) 479-7000

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5950

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement27
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. Orthopaedic Surgery CurrentSince Jan 1, 2009 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 1, 2009 Accepting new patients

Locations

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

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

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

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

1575 N Rivercenter Dr
Ste 160
Milwaukee, WI 53212
Phone (414) 274-7220

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

2999 N Mayfair Rd
Wauwatosa, WI 53222
Phone (414) 479-3737

2424 S 90th St
Ste 500
West Allis, WI 53227
Phone (414) 321-2255

Interoperability endpoints

  • Direct secure messaging: mwichman716@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1437136488",
    "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": "2999 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224306",
            "telephone_number": "414-479-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 N Rivercenter Dr",
            "address_2": "Suite 160",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532123978",
            "country_code": "US",
            "telephone_number": "414-274-7220",
            "fax_number": "414-274-7227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICHMAN",
        "first_name": "MARK",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WI",
            "license": "37933",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "37933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00682036",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32253100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwichman716@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1575 N Rivercenter Dr",
            "address_2": "Suite 160",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532123978",
            "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": "1575 N Rivercenter Dr",
            "address_2": "Suite 160",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532123978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.