James P. Mazzulla, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20804 Issued in WI

Practice address

2500 W Layton Ave
Suite 250
Milwaukee, WI 53221-5420

Phone

(414) 282-2006

Fax

(414) 281-8704

NPI assigned

Sep 12, 2005

Last updated

Nov 20, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment NPD
• Commonwealth Medical Group, LLC

  • Internal Medicine Physician
  • West Allis, WI
  • NPI 1477500361
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1437144946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689711",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532689711",
            "telephone_number": "414-456-3100",
            "fax_number": "414-456-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W LAYTON AVE",
            "address_2": "SUITE 250",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532215420",
            "telephone_number": "414-282-2006",
            "fax_number": "414-281-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZULLA",
        "first_name": "JAMES",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "20804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30321000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debesh Chandra Mazumdar, M.D.
• Samantha Fay Mazur, DNP, RN, CPNP-PC
• Anthony J Mazzeo, MD
• Mary Mazzeo, CAA
• Steven Mazzone, MD
• April Mbida, LCSW
• Terri MC Glaston
• Jamie McAdam, OTR
• Destiny Patricia McAfee, APRN-AGPCNP
• Kate McAghon, OTR/L

• Internal Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.