Active NPI
Melanie Diane Mundinger
- Physician Assistant
- Milwaukee, WI
National Provider Identifier
1487537759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 862823
- Practice address
- 507 N 17TH St
Milwaukee, WI 53233-2104 - Phone
- (414) 288-5688
- NPI assigned
- Jul 25, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | 862823 | WI | Primary |
Addresses
Primary practice location
507 N 17TH St
Milwaukee, WI 53233-2104
Mailing address
507 N 17TH St
Milwaukee, WI 53233-2104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10625 W N Ave
Suite 101
Milwaukee, WI 53226-2315
PO Box
Milwaukee, WI 53288
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 862823 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762387200000",
"number": "1487537759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 N 17TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532332104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 N 17TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532332104",
"telephone_number": "414-288-5688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNDINGER",
"first_name": "MELANIE",
"middle_name": "DIANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-25",
"last_updated": "2025-11-06",
"certification_date": "2025-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "862823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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, 2025; 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.