Organization Active NPI

Midwest Orthopedic Specialty Hospital, LLC

  • Rehabilitation Clinic/Center
  • Mequon, WI
National Provider Identifier
1447950845
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL, LLC
Practice address
1516 W Mequon Rd
Mequon, WI 53092-3264
Phone
(262) 299-6092
Fax
(262) 299-6031
NPI assigned
Mar 6, 2023
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Sheila Gansemer
Title
Ceo
Phone
(414) 325-4589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

1516 W Mequon Rd
Mequon, WI 53092-3264

Mailing address

PO Box 1297
Bedford Park, IL 60499-1297
Phone (262) 299-6092

Other names 1

  • MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL PT Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210317001381 WI Part B Supplier - Clinic/Group Practice 7113078833 Receives reassigned benefits from 101 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Franklin, WI; Wauwatosa, WI; Oak Creek, WI; Muskego, WI; Milwaukee, WI; Mequon, WI; Hales Corners, WI; Brookfield, WI

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1516 W Mequon Rd
Mequon, WI 53092
Phone (262) 299-6092

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1447950845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1297",
            "city": "BEDFORD PARK",
            "state": "IL",
            "postal_code": "604991297",
            "telephone_number": "262-299-6092",
            "fax_number": "262-299-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923264",
            "telephone_number": "262-299-6092",
            "fax_number": "262-299-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "GANSEMER",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-325-4589"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.