Active NPI
Jawairia Sahar K Mirza, MD
- Hospitalist Physician
- West Bend, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 84200
- Practice address
- 3200 Pleasant Valley Rd
West Bend, WI 53095-9274 - Phone
- (262) 334-5553
- Fax
- (262) 836-7301
- NPI assigned
- Apr 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 84200 | WI | |
| Hospitalist Physician | 208M00000X | 84200 | WI | Primary |
Addresses
Primary practice location
3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Mailing address
3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 334-5553
Other practice location 1
4001 N 3rd St Ste 290
Phoenix, AZ 85012-2071
Phone (602) 812-3132
Other practice location 2
350 W Thomas Rd
Phoenix, AZ 85013-4496
Phone (602) 406-2175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619557170 | Medicaid | WI |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666
8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84200 | WI | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226
3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533
Interoperability endpoints
- jmirza838243@direct.froedtert.com
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1255334173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1619557170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 PLEASANT VALLEY RD",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530959274",
"telephone_number": "262-334-5553",
"fax_number": "262-836-7301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 PLEASANT VALLEY RD",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530959274",
"telephone_number": "262-334-5553",
"fax_number": "262-836-7301"
}
],
"practiceLocations": [
{
"address_1": "4001 N 3rd St Ste 290",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850122071",
"country_code": "US",
"telephone_number": "602-812-3132",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "350 W Thomas Rd",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850134496",
"country_code": "US",
"telephone_number": "602-406-2175",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRZA",
"first_name": "JAWAIRIA SAHAR",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-09",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "84200",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WI",
"license": "84200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1619557170",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.