Individual provider Active NPI

Andrew J Marso, DPM

  • Foot Surgery Podiatrist
  • Hales Corners, WI
National Provider Identifier
1699753848
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
896-025 Issued in WI
Practice address
6130 S 108TH Street
Hales Corners, WI 53130-2525
Phone
(414) 425-8400
Fax
(414) 425-8425
NPI assigned
Jan 6, 2006
Last updated
Apr 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 896-025 WI
Foot Surgery Podiatrist 213ES0131X 896-025 WI Primary

Addresses

Primary practice location

6130 S 108TH Street
Hales Corners, WI 53130-2525

Mailing address

6130 S 108TH Street
Hales Corners, WI 53130-2525
Phone (414) 425-8400

Other identifiers 2

IdentifierTypeStateIssuer
P00717384OtherWIRAIL ROAD MEDICARE GROUP MEMBER PTAN #
43239300MedicaidWI

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050606000465 WI Practitioner - Podiatry 9830132471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisconsin Foot Center, LLCGroup PAC ID 2769546985, 2 clinicians
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Practice addresses (Care Compare)

11035 W Forest Home Ave
Suite 120
Hales Corners, WI 53130-2541
Phone (414) 425-8400

6130 S 108TH St
Hales Corners, WI 53130-2525
Phone (414) 425-8400

7200 Washington Ave
Suite 103
Mount Pleasant, WI 53406-6516
Phone (262) 583-0790

Merit-based Incentive Payment System (MIPS)

Final score
81.66 of 100Reported as individual
Quality
63.32
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue123
Removal of skin lesions86
Removal of nail tissue150
Removal or shaving of skin growth77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
896WIMDPediatrics Physician
896-025WIMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Foot Center, LLC Podiatrist CurrentSince Nov 1, 2008 Accepting new patients
Plaza Podiatry Associates LLC Past Accepting new patients
Dr. Steven M Waldman S.C. Podiatrist Past Accepting new patients
Horizon Home Care & Hospice, Inc. Past Accepting new patients

Locations

11035 W Forest Home Ave
Ste 120
Hales Corners, WI 53130
Phone (414) 425-8400

6130 S 108th St
Hales Corners, WI 53130
Phone (414) 425-8400

Interoperability endpoints

  • Direct secure messaging: andy.marso@wfc-wi.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1699753848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 S 108TH STREET",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302525",
            "telephone_number": "414-425-8400",
            "fax_number": "414-425-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 S 108TH STREET",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302525",
            "telephone_number": "414-425-8400",
            "fax_number": "414-425-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSO",
        "first_name": "ANDREW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "896-025",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "WI",
            "license": "896-025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE GROUP MEMBER PTAN #",
            "identifier": "P00717384",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43239300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hales Corners, WI

Sources for this page

Verify at the official NPI Registry.