Individual provider Active NPI

Maura Anzia Brophey, CPNP-PC

  • Pediatric Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1679974117
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
20142077 Issued in WI
Practice address
8915 W Connell Ave
C350
Milwaukee, WI 53226-3067
Phone
(414) 226-6123
NPI assigned
Sep 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 20142077 WI Primary

Addresses

Primary practice location

8915 W Connell Ave
C350
Milwaukee, WI 53226-3067

Mailing address

PO Box 1997
Milwaukee, WI 53201-1997
Phone (414) 226-6123

Other identifiers 1

IdentifierTypeStateIssuer
1679974117MedicaidWI

Other names 1

  • Maura Elizabeth Anzia Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141209002519 WI Practitioner - Nurse Practitioner 7719209360 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20142077WIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Sep 22, 2014 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients
Children'S Specialty Group, Inc. Past Accepting new patients

Locations

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

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: manzia28335@direct.chw.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1679974117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1997",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532011997",
            "telephone_number": "414-226-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 W CONNELL AVE",
            "address_2": "C350",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263067",
            "telephone_number": "414-226-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROPHEY",
        "first_name": "MAURA",
        "middle_name": "ANZIA",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "20142077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679974117",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAURA",
            "last_name": "ANZIA",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.