Shane V. Moisio, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

44961 Issued in WI

Practice address

1919 W North Ave Ste 200
Milwaukee, WI 53205-1101

Phone

(414) 257-7610

Fax

(414) 266-3735

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Specialty

Psychiatry

Education

University of Cincinnati College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mental Health Emergency Center, Inc.Group PAC ID 3274916044, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smoisio409843@direct.myadvocateaurora.org

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.

• Mental Health Emergency Center, Inc.

  • Psychiatric Hospital
  • Milwaukee, WI
  • NPI 1255099941
  Medicare reassignment Care Compare group NPD
• County of Milwaukee

  • Psychologist
  • Milwaukee, WI
  • NPI 1942362066
  Medicare reassignment NPD
• Milwaukee Behavioral Health LLC

  • Psychiatric Hospital
  • Milwaukee, WI
  • NPI 1497324115
  Medicare reassignment NPD
• County of Milwaukee

  • Psychiatric Hospital
  • Milwaukee, WI
  • NPI 1083728612
  NPD
• County of Milwaukee

  • Psychiatry Physician
  • Milwaukee, WI
  • NPI 1831256353
  NPD
• Milwaukee Mental Health Associates, Inc

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1730337338
  NPD (past)
• Milwaukee Mental Health Associates, Inc.

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1154594406
  NPD (past)
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1487601720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 W NORTH AVE STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051101",
            "telephone_number": "414-257-7610",
            "fax_number": "414-266-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 W NORTH AVE STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051101",
            "telephone_number": "414-257-7610",
            "fax_number": "414-266-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOISIO",
        "first_name": "SHANE",
        "middle_name": "V.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "44961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34317100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoisio409843@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1919 W North Ave Ste 200",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532051101",
            "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": "1919 W North Ave Ste 200",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532051101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Syed Hasan Mohiuddin, DO, MS
• Ashley Ann Mohn, PHARMD
• Matthew Ronald Mohorek, M.D.
• Jean Marie Mohr, CERTIFIED OCCUPATION
• Avani Sushilkumar Mohta, M.D.
• Kylie Lynn Moker
• Mohamud Mokoma
• Ruth Buyeke Mokua, DO
• Negar Molazadeh, MD
• Susan Molenaar, APNP

• Child & Adolescent Psychiatry Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Child & Adolescent Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.

Verify at the official NPI Registry.