Marwan Aly, M.D., MPAS, PA-C
Individual provider Active NPI Physician Assistant · Milwaukee, WI
NPI 1609124189 · NPPES record last updated Oct 18, 2023
Key facts
- NPI
- 1609124189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 3299-23 (WI)
- Practice address
- 5800 W Burleigh St
Milwaukee, WI 53210-1516 - Phone
- (414) 442-5400
- Fax
- (414) 442-5468
- NPI assigned
- Aug 15, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 5
Medicare Care Compare profile
- 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.
Aspirus Riverview Hospital and Clinics Inc
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
- Aurora St Lukes Medical Center
- Aspirus Riverview Hospital & Clinics Inc
- Aurora Medical Center Kenosha
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140610002072 | WI | Practitioner - Physician Assistant | 3779707831 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milwaukee Cardiac Care | Current | Accepting new patients | |
| Aurora Advanced Healthcare Inc | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aspirus Riverview Hospital & Clinics, Inc. | Current | Accepting new patients | |
| Medzone LLC | Physician Assistant | Current |
Accepting new patients |
| Lakeshore Medical Clinic, LLC | Current |
Accepting new patients | |
| Divine Savior Healthcare, Inc. | Current |
Accepting new patients | |
| Aspirus Riverview Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Current |
Accepting new patients | |
| Medzone LLC | Physician Assistant | Past |
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
1919 W North Ave
Ste 150
Milwaukee, WI 53205
Phone (414) 395-0009
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
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
420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474
410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257
Interoperability endpoints
- https://api.platform.athenahealth.com/10114/brand/2/csg/1/fhir/r4
- https://api.platform.athenahealth.com/22338/brand/1/csg/1/fhir/r4
- maly103241@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3299-23 | WI | Yes |
Addresses
Primary practice location
5800 W Burleigh St
Milwaukee, WI 53210-1516
Mailing address
5800 W Burleigh St
Milwaukee, WI 53210-1516
Phone (414) 442-5400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100038566 | Medicaid | WI | |
| 1609124189 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | maly103241@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Milwaukee, WI
- Luca Alverno
- Always and Forever Prenatal Care, LLC
- Always There for You
- Alwayz on the Move Transportation Company LLC
- Eman Aly
- Rania Alzubeidi
- Tanya Amal
- Reese Tarik Aman
- Joseph Lee Amaral Jr.
- Elizabeth Amato
All providers in Milwaukee, WI · Physician Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.