Individual provider Active NPI

Mara Pheister, M.D.

  • Psychiatry Physician
  • Milwaukee, WI
National Provider Identifier
1639208440
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
52693 Issued in WI
Practice address
3070 N 51St St Ste 206
Milwaukee, WI 53210-1661
Phone
(414) 585-7020
Fax
(414) 585-7021
NPI assigned
Mar 5, 2007
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 52693 WI Primary

Addresses

Primary practice location

3070 N 51St St Ste 206
Milwaukee, WI 53210-1661

Mailing address

3070 N 51St St Ste 206
Milwaukee, WI 53210-1661
Phone (414) 585-7020

Other practice location 1

W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

Other practice location 2

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7200

Other identifiers 1

IdentifierTypeStateIssuer
1639208440MedicaidWI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090402000070 WI Practitioner - Psychiatry 3971530262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Wisconsin School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

1155 N Mayfair Rd
FL 2
Milwaukee, WI 53226-3462
Phone (414) 955-4263

2153 N Dr Martin Luther King Jr Dr
Suite 2500
Milwaukee, WI 53212-3101
Phone (414) 955-7276

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7200

840 N 87TH St
Milwaukee, WI 53226-3586
Phone (414) 805-5540

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52693WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2016 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Feb 23, 2009 Accepting new patients

Locations

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

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

3070 N 51st St
Ste 206
Milwaukee, WI 53210
Phone (414) 585-7020

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

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

34700 Valley Rd
Oconomowoc, WI 53066

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

1155 N Mayfair Rd
Fl 3
Wauwatosa, WI 53226
Phone (414) 955-8990

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

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

Interoperability endpoints

  • Direct secure messaging: mpheistermd19866@direct.froedtert.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1639208440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N 51ST ST STE 206",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101661",
            "telephone_number": "414-585-7020",
            "fax_number": "414-585-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N 51ST ST STE 206",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101661",
            "telephone_number": "414-585-7020",
            "fax_number": "414-585-7021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W180N8085 Town Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-251-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4805 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517401",
            "country_code": "US",
            "telephone_number": "262-798-7200",
            "fax_number": "262-798-7271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHEISTER",
        "first_name": "MARA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "52693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639208440",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.