Individual provider Active NPI

Khawaja A Ammar, MD

  • Interventional Cardiology Physician
  • Milwaukee, WI
National Provider Identifier
1477528065
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
53467 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy
Suite 175
Milwaukee, WI 53215-3669
Phone
(414) 649-3626
Fax
(414) 385-7157
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 53467 WI Primary
Internal Medicine Physician 207R00000X 53467 WI

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy
Suite 175
Milwaukee, WI 53215-3669

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 389-2377

Other identifiers 4

IdentifierTypeStateIssuer
691824700MedicaidMN
34742200MedicaidWI
ENROLLEDMedicaidIA
P00391254OtherMNRAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kammar20784@direct.myadvocateaurora.org Direct

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091002000443 WI Practitioner - Cardiovascular Disease (Cardiology) 1951342963 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2424 S 90TH St
West Allis, WI 53227-2455
Phone (414) 328-8630

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5930

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

Hospital & facility affiliations

  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting21
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53467WIMDInternal Medicine Physician
19633SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Internal Medicine CurrentSince Nov 1, 2013 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Oct 30, 2020 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Sep 1, 2017 Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Oct 5, 2009 Accepting new patients
Aurora Advanced Healthcare, Inc. Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2013 Accepting new patients
Aurora Health Care Metro, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000

210 Wisconsin American Dr
Fond du Lac, WI 54937
Phone (920) 907-7000

9200 W Loomis Rd
Franklin, WI 53132
Phone (414) 529-9200

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

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

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

2801 W Kinnickinnic River Pkwy
Ste 175
Milwaukee, WI 53215
Phone (414) 649-3626

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2801 S Moorland Rd
New Berlin, WI 53151
Phone (262) 860-7800

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

915 Summit Ave
Summit, WI 53066
Phone (262) 569-2300

1055 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 476-8450

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

2424 S 90th St
Ste 300
West Allis, WI 53227
Phone (414) 328-8150

2424 S 90th St
Ste 310
West Allis, WI 53227
Phone (414) 328-8700

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1477528065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-389-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "SUITE 175",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-649-3626",
            "fax_number": "414-385-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMAR",
        "first_name": "KHAWAJA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "53467",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "53467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691824700",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34742200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00391254",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "Suite 175",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kammar20784@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "Suite 175",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.