Mary K Duffy, AA

Individual provider Active NPI Anesthesiologist Assistant · Summit, WI

NPI 1619625233 · NPPES record last updated Apr 14, 2022

Key facts

NPI
1619625233
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiologist Assistant 367H00000X
License
205-017 (WI)
Practice address
36500 Aurora Dr
Summit, WI 53066-4899
Phone
(262) 434-1000
NPI assigned
Mar 14, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Anesthesiology Assistant
Education
Medical College of Wisconsin, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc. (3,764 clinicians)

Practice addresses (Care Compare)

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

Hospital & facility affiliations

  • Aurora Medical Center - Summit Hospital · Summit, WI · CCN 520206

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220322001704 WI Practitioner - Anesthesiology Assistant 4789079187 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
205-017WIMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current
since Apr 1, 2022
Accepting new patients
Aurora Medical Group, Inc. Current
since Apr 1, 2022
Accepting new patients

Locations

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

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

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

Interoperability endpoints

  • Direct secure messaging: mduffy333182@direct.myadvocateaurora.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 205-017 WI Yes

Addresses

Primary practice location

36500 Aurora Dr
Summit, WI 53066-4899

Mailing address

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-1000

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address mduffy333182@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Other providers in Summit, WI

All providers in Summit, WI · Anesthesiologist Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.