Active NPI
Melissa D Brenner, PA-C
- Physician Assistant
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4142
- Practice address
- 945 N 12TH St
Milwaukee, WI 53233-1305 - Phone
- (414) 219-2000
- NPI assigned
- Aug 11, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4142 | WI | Primary |
Addresses
Primary practice location
945 N 12TH St
Milwaukee, WI 53233-1305
Mailing address
945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100072135 | Medicaid | WI |
Other names 1
- Melissa D Hazard
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mhazard192899@aurora.direct-ci.com | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056
248 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-8000
252 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-7000
Hospital & facility affiliations
- Aurora St Lukes Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4142 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients |
Locations
945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
Interoperability endpoints
- mhazard192899@aurora.direct-ci.com
Organizations & group practices 2
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Cudahy, WI
- NPI 1235355983
Hospital
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1861447179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1477078368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 N 12TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331305",
"telephone_number": "414-219-7021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 N 12TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532331305",
"telephone_number": "414-219-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNER",
"first_name": "MELISSA",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-11",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "4142",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100072135",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mhazard192899@aurora.direct-ci.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "945 N 12th St",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532331305",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "945 N 12th St",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532331305",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "HAZARD",
"middle_name": "D",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.