Individual provider Active NPI

Nana Kyerewa Tabi Nsiah, M.D.

  • Addiction Psychiatry Physician
  • Wauwatosa, WI
National Provider Identifier
1508039611
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
5688520 Issued in WI
Practice address
1220 Dewey Avenue
Aurora Behavioral Health Services
Wauwatosa, WI 53213
Phone
(414) 454-6754
Fax
(414) 454-6600
NPI assigned
Apr 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35097403 OH
Student in an Organized Health Care Education/Training Program 390200000X
Addiction Psychiatry Physician 2084P0802X 5688520 WI Primary

Addresses

Primary practice location

1220 Dewey Avenue
Aurora Behavioral Health Services
Wauwatosa, WI 53213

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (414) 454-6753

Other identifiers 1

IdentifierTypeStateIssuer
100030578MedicaidWI

Other names 1

  • Ms. Nana Kyerewa Ampofo-Twumasi Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ntabinsiah61897@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130719000332 WI Practitioner - Psychiatry 1153562038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Mental Health Emergency Center, Inc.Group PAC ID 3274916044, 24 clinicians

Practice addresses (Care Compare)

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

1220 Dewey Ave
Wauwatosa, WI 53213-2504
Phone (414) 773-4312

1525 N 12TH St
Milwaukee, WI 53205-2591
Phone (414) 966-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35097403OHMDPsychiatry Physician
5688520WIMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jul 29, 2013 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 29, 2013 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Mental Health Emergency Center, Inc. CurrentSince Sep 6, 2022 Accepting new patients

Locations

2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817

1525 N 12th St
Milwaukee, WI 53205
Phone (414) 966-3030

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

1220 Dewey Ave
Wauwatosa, WI 53213
Phone (414) 454-6600

Interoperability endpoints

  • Direct secure messaging: ntabinsiah61897@direct.myadvocateaurora.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1508039611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "414-454-6753",
            "fax_number": "414-454-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 DEWEY AVENUE",
            "address_2": "AURORA BEHAVIORAL HEALTH SERVICES",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53213",
            "telephone_number": "414-454-6754",
            "fax_number": "414-454-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABI NSIAH",
        "first_name": "NANA",
        "middle_name": "KYEREWA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35097403",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "WI",
            "license": "5688520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100030578",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntabinsiah61897@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1220 Dewey Avenue",
            "address_2": "Aurora Behavioral Health Services",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53213",
            "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": "1220 Dewey Avenue",
            "address_2": "Aurora Behavioral Health Services",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NANA",
            "last_name": "AMPOFO-TWUMASI",
            "middle_name": "KYEREWA",
            "prefix": "MS.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.