Individual provider Active NPI

Robert Hoogstra, MD

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1629171244
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
65880 Issued in WI
Practice address
9200 W Wisconsin Ave
Emergency Medicine
Milwaukee, WI 53226-3522
Phone
(414) 805-6450
Fax
(414) 805-6464
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 65880 WI
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4301053477 MI
Emergency Medicine Physician 207P00000X 65880 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Emergency Medicine
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Emergency Medicine
Milwaukee, WI 53226-3522
Phone (414) 805-6450

Other identifiers 3

IdentifierTypeStateIssuer
010039469OtherMIRAILROAD MEDICARE
RH053477OtherMIBCBS
1629171244MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070710000455 MI Practitioner - Emergency Medicine 6406749118 Reassigns benefits to 2 organizations
I20160726000788 WI Practitioner - Emergency Medicine 6406749118 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
65880WIMDEmergency Medicine Physician
4301053477MIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Michigan Observation Services PLLC Emergency Medical Services CurrentSince Jan 1, 2022 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Lake Michigan Emergency Specialists, PLLC Emergency Medicine CurrentSince Jan 1, 2017 Accepting new patients
The Medical College of Wisconsin, Inc. Emergency Medicine CurrentSince Jul 15, 2016 Accepting new patients

Locations

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511

72 S State St
Shelby, MI 49455
Phone (231) 728-4601

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

4805 S Moorland Rd
New Berlin, WI 53151
Phone (262) 798-7200

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1629171244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "EMERGENCY MEDICINE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "EMERGENCY MEDICINE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOGSTRA",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "65880",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301053477",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "65880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010039469",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "RH053477",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629171244",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.