Individual provider Active NPI

Liza E Mathson, APNP

  • Women's Health Nurse Practitioner
  • Wauwatosa, WI
National Provider Identifier
1578886578
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
3990 Issued in WI
Practice address
201 N Mayfair Rd
3Rd Floor
Wauwatosa, WI 53226-4216
Phone
(414) 259-7480
Fax
(414) 256-4482
NPI assigned
Mar 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 3990 WI Primary

Addresses

Primary practice location

201 N Mayfair Rd
3Rd Floor
Wauwatosa, WI 53226-4216

Mailing address

PO Box 689711
Milwaukee, WI 53268-0001
Phone (888) 414-2509

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100812001033 WI Practitioner - Nurse Practitioner 5698809630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Wisconsin School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 N Mayfair Rd
Wauwatosa, WI 53226-4216

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2569

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3990WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Mar 4, 2010 Accepting new patients
St. Luke's Health Services, Inc. Past Accepting new patients
Ascension All Saints Hospital, Inc Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

201 N Mayfair Rd
Fl 3
Wauwatosa, WI 53226
Phone (414) 259-7480

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1578886578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689711",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532680001",
            "telephone_number": "888-414-2509",
            "fax_number": "414-456-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "address_2": "3RD FLOOR",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-259-7480",
            "fax_number": "414-256-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHSON",
        "first_name": "LIZA",
        "middle_name": "E",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WI",
            "license": "3990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.