Active NPI
Mark E. Nordness, M.D.
- Allergy & Immunology Physician
- Mukwonago, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 41406
- Practice address
- 240 Maple Avenue
Prohealth Care Medical Associates Inc.
Mukwonago, WI 53149 - Phone
- (262) 928-1900
- Fax
- (262) 363-1949
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 41406 | WI | Primary |
| Pediatrics Physician | 208000000X | 41406-020 | WI |
Addresses
Primary practice location
240 Maple Avenue
Prohealth Care Medical Associates Inc.
Mukwonago, WI 53149
Mailing address
N17 W24100 Riverwood Drive Suite 250
Prohealth Care Medical Associates Inc.
Waukesha, WI 53149
Phone (262) 928-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34064800 | Medicaid | WI |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- Medical College of Wisconsin, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808
Hospital & facility affiliations
- Waukesha Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41406-020 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc. | Allergy & Immunology | Current | Accepting new patients |
| Prohealth Medical Group Inc | Current | Accepting new patients | |
| Prohealth Medical Group Inc | Allergy & Immunology | Past | Accepting new patients |
Locations
195 Discovery Dr
Brookfield, WI 53045
Phone (262) 513-7100
W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000
400 Bay View Rd
Mukwonago, WI 53149
Phone (262) 363-1900
240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900
N17W24100 Riverwood Dr
Ste 250
Waukesha, WI 53188
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030
N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696
Interoperability endpoints
- mnordness15533@direct.phci.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Hartland, WI
- NPI 1386785178
-
- Family Medicine Physician
- Waukesha, WI
- NPI 1790720613
Allergy & Immunology
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Waukesha, WI
- NPI 1629056890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1457324428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N17 W24100 RIVERWOOD DRIVE SUITE 250",
"address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "53149",
"telephone_number": "262-928-4100",
"fax_number": "262-928-5835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 MAPLE AVENUE",
"address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
"city": "MUKWONAGO",
"state": "WI",
"postal_code": "53149",
"telephone_number": "262-928-1900",
"fax_number": "262-363-1949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORDNESS",
"first_name": "MARK",
"middle_name": "E.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "WI",
"license": "41406",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "41406-020",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34064800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mukwonago, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.