Mark H Hermanoff, MD
Individual provider Active NPI Allergy & Immunology (Internal Medicine) Physician · Summit, WI
NPI 1447309786 · NPPES record last updated Apr 30, 2024
Key facts
- NPI
- 1447309786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Allergy & Immunology (Internal Medicine) Physician 207RA0201X
- License
- 40807 (WI)
- Practice address
- 36500 Aurora Dr
Summit, WI 53066-4899 - Phone
- (262) 434-5000
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 27
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Allergy/Immunology
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Aurora Advanced Healthcare, Inc.
Aurora Medical Group, Inc.
Practice addresses (Care Compare)
1055 N Mayfair Rd
Wauwatosa, WI 53226-3436
Phone (414) 476-8450
36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000
Hospital & facility affiliations
- Aurora St Lukes Medical Center
- Aurora Medical Center - Summit
- Aurora Medical Center
- Aurora Medical Ctr Washington County
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050112000242 | WI | Practitioner - Allergy/Immunology | 3274581616 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Lakeshore Medical Clinic LTD | Current |
Accepting new patients | |
| Lakeshore Medical Clinic, LLC | Current |
Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Allergy & Immunology | Current |
Accepting new patients |
| Aurora Advanced Healthcare Inc | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
1004 E Sumner St
Hartford, WI 53027
Phone (262) 670-7000
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444
S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747
200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590
2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461
1061 E Commerce Blvd
Slinger, WI 53086
Phone (262) 644-2900
2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880
36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000
915 Summit Ave
Summit, WI 53066
Phone (262) 569-2300
10400 W North Ave
Wauwatosa, WI 53226
Phone (414) 479-2300
1055 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 476-8450
205 Valley Ave
West Bend, WI 53095
Phone (262) 338-1123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology (Internal Medicine) Physician | 207RA0201X | 40807 | WI | Yes |
Addresses
Primary practice location
36500 Aurora Dr
Summit, WI 53066-4899
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32516900 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mhermanoff12232@direct.myadvocateaurora.org | ||
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Summit, WI
- Lisa L Harshbarger
- Travis M Hecker
- MHD Kher Heder
- Joseph H Helm III
- Nicholas R Hempeck
- Benjamin P Hermanson
- Amy Hess
- Cynthia Hesse
- Mark A Hlava
- Lauren Hoesly
All providers in Summit, WI · Allergy & Immunology (Internal Medicine) Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.