John P Mullooly II, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35617020 Issued in WI

Practice address

1220 N Dewey Ave
Milwaukee, WI 53213

Phone

(414) 454-6610

Fax

(414) 454-6644

NPI assigned

Oct 27, 2006

Last updated

Apr 11, 2013By the provider in NPPES

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aurora Psychiatric Hospital, Inc.

  • Psychiatric Hospital
  • Wauwatosa, WI
  • NPI 1881627438

  Psychiatry

  Medicare reassignment NPD
• Affinity Health Care LLC

  • Adult Mental Health Clinic/Center
  • Wind Lake, WI
  • NPI 1952663619
  NPD (past)
• Brotoloc Outpatient Clinic

  dba Brotoloc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Allis, WI
  • NPI 1700928017
  NPD (past)
• Milwaukee Psychiatric Physicians Chartered

  • Psychiatry Physician
  • Brookfield, WI
  • NPI 1588739155
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1649356254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 DEWEY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532132504",
            "telephone_number": "414-454-6514",
            "fax_number": "414-454-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N DEWEY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53213",
            "telephone_number": "414-454-6610",
            "fax_number": "414-454-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLOOLY",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "35617020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Mullin
• Michael P Mullin, D.O.
• Alysia L Mullins, PEER SPECIALIST
• Caitlin Mullins, PHARMD
• Janet Mullins
• Maeve Evelyn Keane Mullooly
• William P. Mullooly, APSW
• Gregory W Mulry, LCSW
• Multi Cultural Padilla 24 HR Supportive Care
• Multi-Cultural Counseling Services II Inc. (Renew Counseling Services)

• Psychiatry Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.