Edmund J Fernandez, MD
Individual provider Active NPI Family Medicine Physician · Slinger, WI
NPI 1669587739 · NPPES record last updated Dec 1, 2021
Key facts
- NPI
- 1669587739
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 42228 (WI)
- Practice address
- 1061 E Commerce Blvd
Slinger, WI 53086 - Phone
- (262) 644-2900
- Fax
- (262) 644-2980
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 25
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Advanced Healthcare, Inc.
Practice addresses (Care Compare)
1061 E Commerce Boulevard
Slinger, WI 53086-9326
Phone (262) 644-2900
12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200
1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000
Hospital & facility affiliations
- Aurora Medical Ctr Washington County
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040907001298 | WI | Practitioner - Family Practice | 2769458132 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Advanced Healthcare Inc | Current |
Accepting new patients | |
| Lakeshore Medical Clinic, LLC | Family Medicine | Current |
Accepting new patients |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Family Medicine | Current |
Accepting new patients |
| Aurora Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current |
Accepting new patients |
Locations
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200
1004 E Sumner St
Hartford, WI 53027
Phone (262) 670-7000
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747
14555 W National Ave
Ste 140
New Berlin, WI 53151
Phone (262) 827-0480
200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590
1061 E Commerce Blvd
Slinger, WI 53086
Phone (262) 644-2900
2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880
Interoperability endpoints
- efernandez13375@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 42228 | WI | Yes |
Addresses
Primary practice location
1061 E Commerce Blvd
Slinger, WI 53086
Mailing address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00941442 | Other | WI | RR MEDICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | efernandez13375@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Slinger, WI
- Sharon Gertrude Crooks
- Kelli Darin
- Meghan Dassow
- Abigail Davis
- Delta LLC
- Sarah Kennedy Fodor
- Melissa Folstad
- Fresenius Medical Care Milwaukee, LLC
- Friedemann Chiropractic LLC
- Thomas J Friedemann
All providers in Slinger, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.