Maryam Shittu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

63075-20 Issued in WI

Practice address

3333 S Sunny Slope Rd Ste 108
New Berlin, WI 53151-4504

Phone

(262) 317-9660

Fax

(262) 317-9650

NPI assigned

Aug 17, 2012

Sex

Female

Sole proprietor

Yes

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 3

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

Specialty

Internal Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Ascension Medical Group-Fox Valley Wisconsin, IncGroup PAC ID 0244142420, 260 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension NE Wisconsin - St Elizabeth Campus Hospital, Appleton, WI, CCN 520009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mshittu161555@direct.thedacare.org

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.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  dba Ascension Medical Group

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Ascension NE Wisconsin, Inc

  dba Ascension NE Wisconsin-St Elizabeth Campus

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1407803638
  Medicare reassignment NPD
• Baycare Aurora, LLC

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1255387726
  Medicare reassignment NPD
• Thedacare, Incorporated

  dba ThedaCare Physicians

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Blue Horizen Wellness

  dba Medi weightloss

  • Family Medicine Physician
  • New Berlin, WI
  • NPI 1518857416
  NPD Authorized official
• Columbia St. Mary'S Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482
  Medicare reassignment
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD
• Ascension NE Wisconsin, Inc

  dba Ascension NE Wisconsin-Mercy Campus

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1912527193
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Aurora Medical Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1659599157
  NPD

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

• Ascension NE Wisconsin, Inc

  • Ambulatory Surgical Clinic/Center
  • Menasha, WI
  • NPI 1124075536

  Hospital

  Care Compare affiliation
• Ascension NE Wisconsin, Inc

  dba Ascension NE Wisconsin-St Elizabeth Campus

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1407803638
  Care Compare affiliation

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1689922882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S SUNNY SLOPE RD STE 108",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514504",
            "telephone_number": "262-317-9660",
            "fax_number": "262-317-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S SUNNY SLOPE RD STE 108",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514504",
            "telephone_number": "262-317-9660",
            "fax_number": "262-317-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHITTU",
        "first_name": "MARYAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-17",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "63075-20",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100040739",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshittu@mediweightlossclinics.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3333 S Sunny Slope Rd Ste 108",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531514504",
            "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": "1715 Dousman St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543033211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshittu357221@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1715 Dousman St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543033211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph Charles Serflek, DDS
• Keerthi Shabadu, DDS
• Margaret Louise Shane, OT
• Lisa Sheehan
• Cynthia Louise Shicotte, MA, CCC/SLP
• Ali H Siddiqui, MD
• Tahmeena Siddiqui I, PHARMD
• Elizabeth A. Silver, M.D.
• Scott Alan Simkowski, D.C.
• Stephanie Taylor Simms, NP

• Internal Medicine Physician in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.