Michael P Fetherston, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21674 Issued in WI

Practice address

9233 N Green Bay Rd
Brown Deer, WI 53209-1103

Phone

(414) 270-8150

NPI assigned

Mar 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Medical College of Wisconsin, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Horizon Home Care and Hospice Home health agency, Milwaukee, WI, CCN 527083
• Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Orthopaedic Hospital of Wisconsin Hospital, Glendale, WI, CCN 520194

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Columbia St. Mary's Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Columbia St. Mary's Hospital Milwaukee Inc

  dba Ascension Columbia St Mary's Hospital Ozaukee

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD

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

• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Columbia St. Mary's Hospital Milwaukee, Inc.

  dba Ascension Columbia St Mary's Hospital Milwaukee Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1871656082
  Care Compare affiliation
• Horizon Home Care & Hospice, Inc.

  • Home Health Agency
  • Milwaukee, WI
  • NPI 1780687327
  Care Compare affiliation
• Orthopaedic Hospital of Wisconsin, LLC

  dba Orthopaedic Hospital of Wisconsin

  • General Acute Care Hospital
  • Glendale, WI
  • NPI 1669584983
  Care Compare affiliation

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1639130040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-270-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9233 N GREEN BAY RD",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091103",
            "telephone_number": "414-270-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETHERSTON",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "21674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30242300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Fajardo
• Debra Farrington, MSW
• Fast Laine Transport II
• Feinman & Himden D.D.S., S.C.
• Robert Feinman, D.D.S.
• Kristie J. Fleurimond, MS, LPC
• Kathryn Ford, MS
• Raphael Ford
• Shawanda Ford, MA
• Mackenzie Francis

• Family Medicine Physician in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.

Verify at the official NPI Registry.