Mario R Powell, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

46494 Issued in WI

Practice address

975 Port Washington Rd
Division of Neonatology
Grafton, WI 53024-9201

Phone

(262) 329-1000

NPI assigned

May 17, 2006

Last updated

Sep 17, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mario Powell MD SC

  • Neonatal-Perinatal Medicine Physician
  • Milwaukee, WI
  • NPI 1174023907
  NPD Authorized official
• Newborn Care Physicians of Southeastern Wisconsin, LLP

  • Neonatal-Perinatal Medicine Physician
  • Brookfield, WI
  • NPI 1790241222
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1609828391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 PORT WASHINGTON RD",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 PORT WASHINGTON RD",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "MARIO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WI",
            "license": "46494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter J Polewski, MD
• Kaylee Lynn Popp, FNP-C
• Christopher David Potter, DPT
• Megan Potter, DPT
• Timothy Jaron Pow, M.D.
• PRN Eye Associates LLC
• Elaine Danielle Proefrock
• Tracy Ann Prohuska, RN
• Quirt Family Dentistry, SC (Dental Care of Grafton)
• Benjamin A Quist, DPT CSCS

• Neonatal-Perinatal Medicine Physician in Grafton, WI
• Providers in Grafton, WI by specialty
• Neonatal-Perinatal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.