Individual provider Active NPI

Marwan Aly, M.D., MPAS, PA-C

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1609124189
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3299-23 Issued in WI
Practice address
945 N 12TH St
Milwaukee, WI 53233-1305
Phone
(414) 219-2000
Fax
(414) 219-6775
NPI assigned
Aug 15, 2012
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3299-23 WI Primary

Addresses

Primary practice location

945 N 12TH St
Milwaukee, WI 53233-1305

Mailing address

Pob Ox 735044
Chicago, IL 60673-0001
Phone (800) 326-2250

Other practice location 1

5800 W Burleigh St
Milwaukee, WI 53210-1516
Phone (414) 442-5400

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address maly103241@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140610002072 WI Practitioner - Physician Assistant 3779707831 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
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

Practice addresses (Care Compare)

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

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

13250 Washington Ave
Mount Pleasant, WI 53177-1516
Phone (262) 884-4000

2031 Peach St
Wisconsin Rapids, WI 54494-5181
Phone (715) 423-0122

410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone (715) 423-6060

6901 W Edgerton Ave
Milwaukee, WI 53220-4420
Phone (414) 421-8400

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

975 Port Washington Rd
Grafton, WI 53024-9204
Phone (262) 329-8650

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medzone LLC Physician Assistant CurrentSince Oct 1, 2025 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jul 29, 2017 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Jun 8, 2024 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Sep 17, 2021 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Sep 17, 2021 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jul 15, 2020 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 14, 2014 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Jun 8, 2024 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jul 15, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 14, 2014 Accepting new patients
Milwaukee Cardiac Care Current Accepting new patients
Medzone LLC Physician Assistant PastSince Oct 1, 2025 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

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

1919 W North Ave
Ste 150
Milwaukee, WI 53205
Phone (414) 395-0009

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

331 E Puetz Rd
Ste 104
Oak Creek, WI 53154
Phone (414) 570-3590

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10114/brand/2/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/22338/brand/1/csg/1/fhir/r4
  • Direct secure messaging: maly103241@direct.myadvocateaurora.org

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 5

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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1609124189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB OX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606730001",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-2000",
            "fax_number": "414-219-6775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5800 W Burleigh St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532101516",
            "country_code": "US",
            "telephone_number": "414-442-5400",
            "fax_number": "414-442-5468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALY",
        "first_name": "MARWAN",
        "name_prefix": "Dr.",
        "credential": "M.D., MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3299-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maly103241@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5800 W Burleigh St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532101516",
            "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": "5800 W Burleigh St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532101516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.