Edward James Muellerleile, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

36573 Issued in WI

Practice address

4267 W Fond Du Lac Ave
Milwaukee, WI 53216-3527

Phone

(414) 873-3440

Fax

(414) 873-3420

NPI assigned

Feb 9, 2007

Last updated

Nov 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edward.muellerleile@sepeds.directbygreenway.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Samir Mullick MD SC

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1235182221
  Medicare reassignment NPD

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1477694818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4267 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163527",
            "telephone_number": "414-873-3440",
            "fax_number": "414-873-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4267 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163527",
            "telephone_number": "414-873-3440",
            "fax_number": "414-873-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLERLEILE",
        "first_name": "EDWARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "36573",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WI",
            "license": "36573",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32466900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel David Mueller, PHARMD
• Richard John Mueller, PHARMD
• Robert Mueller, PHARMD
• Teri Mikolic Mueller
• Wade Mueller, MD
• Jared Ross Muench, MD
• Kelley Muench, PA
• Zachary Muench, PA
• Jamie Lynn Muetzelburg, MS, LPC, CSAC
• Keirsen Muffler, MA, CCC-A

• Pediatrics Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.