Organization Active NPI

Midwest Rehabilitation Associates, S.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wauwatosa, WI
National Provider Identifier
1598877375
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
MIDWEST REHABILITATION ASSOCIATES, S.C.
Practice address
2525 N Mayfair Rd
Suite 200
Wauwatosa, WI 53226-1403
Phone
(414) 476-8183
Fax
(414) 476-8465
NPI assigned
Aug 31, 2006
Last updated
Dec 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Mrs. Mary Wright
Title
Executive Director
Phone
(414) 476-8183

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Psychologist 103T00000X
Clinical Psychologist 103TC0700X
Health Service Psychologist 103TH0100X
Group Psychotherapy Psychologist 103TP2701X
Clinical Social Worker 1041C0700X
Physical Medicine & Rehabilitation Physician 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X Primary
Neurology Physician 2084N0400X
Clinical Neurophysiology Physician 2084N0600X
Pain Medicine Physician 208VP0000X
Occupational Therapy Assistant 224Z00000X
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Electroneurodiagnostic Specialist/Technologist 246ZE0600X

Addresses

Primary practice location

2525 N Mayfair Rd
Suite 200
Wauwatosa, WI 53226-1403

Mailing address

2525 N Mayfair Rd
Suite 200
Wauwatosa, WI 53226-1403
Phone (414) 476-8183

Other identifiers 2

IdentifierTypeStateIssuer
21280000MedicaidWI
137184000OtherWIUS DEPT OF LABOR ID

National Provider Directory

National Provider Directory

Locations

2015 E Newport Ave
#607
Milwaukee, WI 53211

2525 N Mayfair Rd
Ste 20
Wauwatosa, WI 53226
Phone (414) 476-8183

2525 N Mayfair Rd
Ste 200
Wauwatosa, WI 53226
Phone (414) 476-8183

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1598877375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 N MAYFAIR RD",
            "address_2": "SUITE 200",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261403",
            "telephone_number": "414-476-8183",
            "fax_number": "414-476-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 N MAYFAIR RD",
            "address_2": "SUITE 200",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261403",
            "telephone_number": "414-476-8183",
            "fax_number": "414-476-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST REHABILITATION ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "414-476-8183",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21280000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR ID",
            "identifier": "137184000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.