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
Hospital & facility affiliations 1
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.
Practice addresses (Care Compare)
36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000
Hospital & facility affiliations
- Aurora Medical Center - Summit
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220322001704 | WI | Practitioner - Anesthesiology Assistant | 4789079187 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205-017 | WI | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
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
- mduffy333182@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mduffy333182@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Summit, WI
- Andrew Roger Dodd
- Andrea Donaldson
- Dennis Guy Dorow
- Michael L Douglass
- Kathleen Mary Duffy
- Erica M Dziatkiewicz
- Sara Ebsen
- David J Eggert
- Kevin L Eggleston
- Mikayla Nicole Ehlert
All providers in Summit, WI · Anesthesiologist 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 Apr 14, 2022. 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.
- 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.