Individual provider Active NPI

Heather Marie Wells-Holtey, MD

  • Dermatology Physician
  • Milwaukee, WI
National Provider Identifier
1447320403
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
41524 Issued in WI
Practice address
2350 N. Lake Drive
Suite 300
Milwaukee, WI 53211-4528
Phone
(414) 298-7100
Fax
(414) 298-7101
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 41524 WI Primary

Addresses

Primary practice location

2350 N. Lake Drive
Suite 300
Milwaukee, WI 53211-4528

Mailing address

788 N Jefferson St
Suite 300 /Attn Kaaren Butzen
Milwaukee, WI 53202-3718
Phone (414) 227-8950

Other identifiers 1

IdentifierTypeStateIssuer
1447320403MedicaidWI

Other names 1

  • Heather Marie Wells-Holtey Other name

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
I20040805000156 WI Practitioner - Dermatology 0941271647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Wisconsin School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Medical Affiliates IncGroup PAC ID 5991606337, 86 clinicians

Practice addresses (Care Compare)

2350 N Lake Dr
Suite 300
Milwaukee, WI 53211-4528
Phone (414) 298-7100

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions530
Removal or shaving of skin growth30
Skin biopsy124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41524WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Medical Affiliates, Inc. CurrentSince Jan 1, 2008 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Current Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince May 31, 2018 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince May 31, 2018 Accepting new patients

Locations

7423 Solutions Ctr
Chicago, IL 60677

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

13133 N Port Washington Rd
Ste G01
Mequon, WI 53097
Phone (262) 243-2500

12831 N Port Washington Rd
Mequon, WI 53097
Phone (262) 643-1300

788 N Jefferson St
Ste 300
Milwaukee, WI 53202
Phone (414) 272-8950

9252 N Green Bay Rd
Fl 2
Milwaukee, WI 53209
Phone (414) 270-8150

2350 N Lake Dr
Ste 300
Milwaukee, WI 53211
Phone (414) 298-7100

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

788 N Jefferson St
Ste 401
Milwaukee, WI 53202
Phone (414) 226-4020

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1447320403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST",
            "address_2": "SUITE 300 /ATTN KAAREN BUTZEN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023718",
            "telephone_number": "414-227-8950",
            "fax_number": "414-272-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N. LAKE DRIVE",
            "address_2": "SUITE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-298-7100",
            "fax_number": "414-298-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS-HOLTEY",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "41524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447320403",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WELLS-HOLTEY",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.