Kimiyo M Masaka, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

13017-33 Issued in WI

Practice address

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669

Phone

(414) 384-5111

NPI assigned

Jul 5, 2022

Last updated

Aug 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Health Care Metro, Inc.Group PAC ID 8628986536, 75 clinicians

Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
• West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmasaka226075@direct.myadvocateaurora.org
• Direct secure messaging: kmasakarn214303@direct.froedtert.com

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 Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  Medicare reassignment Care Compare group NPD
• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment Care Compare group

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

• Aurora Health Care Metro, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cudahy, WI
  • NPI 1235355983

  Hospital

  Care Compare affiliation
• Aurora Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  Care Compare affiliation
• West Allis Memorial Hospital, Inc.

  dba Aurora West Allis Medical Center

  • Clinic/Center
  • West Allis, WI
  • NPI 1235345695

  Hospital

  Care Compare affiliation
• West Allis Memorial Hospital, Inc.

  dba Aurora West Allis Medical Center

  • General Acute Care Hospital
  • West Allis, WI
  • NPI 1407801640
  Care Compare affiliation

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1669105979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735031",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735031",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-384-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-6850",
            "fax_number": "414-805-6864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8850 William Coffey Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532261264",
            "country_code": "US",
            "telephone_number": "414-805-3666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASAKA",
        "first_name": "KIMIYO",
        "middle_name": "M",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13017-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "235093-30",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100205910",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmasaka226075@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary T Breger MDSC
• Maryann Adult Family Home LLC
• Marys Adult Family Services LLC (Mafhs, LLC.)
• Sara Marzinski, DNP, RN, AGCNS-BC
• Maria Mas, MD
• Lauren H. Mascari, PHD, LP, NCC
• Jorge Gilberto Mascaro Carvajal, MD, FRCS
• Jack Melvin Masche, D.C.
• Jonathan Paul Maschke, APSW
• John Phillip Masel, D.D.S.

• Nurse Practitioner in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.