Individual provider Active NPI

Zarah Rose Maccoux, CNM

  • Advanced Practice Midwife
  • Milwaukee, WI
National Provider Identifier
1689007890
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
148881-32 Issued in WI
Practice address
2555 N Dr Martin Luther King Jr Dr
Milwaukee, WI 53212-2709
Phone
(414) 372-8080
Fax
(414) 562-8447
NPI assigned
Aug 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 175043-30 WI
Nurse Practitioner 363L00000X 5485-33 WI
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 5485-33 WI
Advanced Practice Midwife 367A00000X 148881-32 WI Primary

Addresses

Primary practice location

2555 N Dr Martin Luther King Jr Dr
Milwaukee, WI 53212-2709

Mailing address

2555 N Martin Luther King Dr
Milwaukee, WI 53212-2709
Phone (414) 372-8080

Other practice location 1

8200 W Silver Spring Dr
Milwaukee, WI 53218-2552
Phone (414) 760-3900

Other identifiers 2

IdentifierTypeStateIssuer
100035015MedicaidWI
0000002690OtherWIMEDICARE PTAN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131220001563 WI Practitioner - Certified Nurse Midwife (CNM) 3779710637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milwaukee Health Services, Inc.Group PAC ID 7416946884, 27 clinicians

Practice addresses (Care Compare)

2555 N Dr Martin Luther King Dr
Milwaukee, WI 53212-2709
Phone (414) 372-8080

2555 N Dr Martin Luther King Jr Dr
Milwaukee, WI 53212-2709

8200 W Silver Spring Dr
Milwaukee, WI 53218-2552
Phone (414) 760-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
175043-30WIMDRegistered Nurse
5485-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Health Services, Inc. CurrentSince Dec 1, 2013 Accepting new patients
Milwaukee Health Services Inc CurrentSince Dec 1, 2013 Accepting new patients

Locations

2555 N Mlk Dr
Milwaukee, WI 53212
Phone (414) 267-2022

8200 W Silver Spring Dr
Milwaukee, WI 53218
Phone (414) 760-3900

Interoperability endpoints

  • Direct secure messaging: zmaccoux526482@direct.ochin.org

Organizations & group practices 2

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": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1689007890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 N MARTIN LUTHER KING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-372-8080",
            "fax_number": "414-562-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 N DR MARTIN LUTHER KING JR DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-372-8080",
            "fax_number": "414-562-8447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8200 W Silver Spring Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532182552",
            "country_code": "US",
            "telephone_number": "414-760-3900",
            "fax_number": "414-464-7769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACCOUX",
        "first_name": "ZARAH",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "175043-30",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5485-33",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "WI",
            "license": "5485-33",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WI",
            "license": "148881-32",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100035015",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0000002690",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.