NPIMap

Organization Active NPI

Maple Medical SC

  • Physical Medicine & Rehabilitation Physician
  • Waukesha, WI
National Provider Identifier
1487152104
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MAPLE MEDICAL SC
Practice address
2428 N Grandview Blvd Ste 102
Waukesha, WI 53188-6906
Phone
(877) 307-3226
Fax
(877) 307-3226
NPI assigned
Jan 28, 2018
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Harry Hostetler, MDNPI 1093775090
Title
Owner
Phone
(262) 875-5070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

2428 N Grandview Blvd Ste 102
Waukesha, WI 53188-6906

Mailing address

PO Box 474
Hartland, WI 53029-0474
Phone (877) 307-3226

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180328002607 WI Part B Supplier - Clinic/Group Practice 9032471248 Receives reassigned benefits from 139 practitioners
Practice locations: New Berlin, WI; Waukesha, WI

National Provider Directory

National Provider Directory

Locations

1755 N Barker Rd
Brookfield, WI 53045
Phone (262) 534-7297

838 E Veterans Way
Mukwonago, WI 53149

2428 N Grandview Blvd
Ste 102
Waukesha, WI 53188
Phone (262) 875-5070

Practitioners & affiliated clinicians

Practitioners 152

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.

View all 152

NPI Registry JSON

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

{
    "created_epoch": "1517097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1487152104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530290474",
            "telephone_number": "877-307-3226",
            "fax_number": "866-384-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 N GRANDVIEW BLVD STE 102",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531886906",
            "telephone_number": "877-307-3226",
            "fax_number": "877-307-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE MEDICAL SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-28",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "HOSTETLER",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-875-5070",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.