Active NPI
Antonio Ippolito Montemurro, DPM
- Primary Podiatric Medicine Podiatrist
- Pleasant Prairie, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- 1031-25
- Practice address
- 9697 Saint Catherines Dr Ste 300
Pleasant Prairie, WI 53158-2118 - Phone
- (262) 656-3338
- Fax
- (262) 656-3368
- NPI assigned
- Feb 15, 2013
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 016005538 | IL | |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 1031-25 | WI | Primary |
Addresses
Primary practice location
9697 Saint Catherines Dr Ste 300
Pleasant Prairie, WI 53158-2118
Mailing address
6308 8TH Ave
Kenosha, WI 53143-5031
Phone (262) 656-3313
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700126562 | Medicaid | WI | |
| K400163324 | Other | WI | MEDICARE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advantage Physical Therapy and Sports Rehab, LLC
Practice addresses (Care Compare)
10222 74TH St
Suite 211
Kenosha, WI 53142-6810
Phone (262) 925-5020
6308 8TH Ave
Kenosha, WI 53143-5031
Phone (262) 653-5300
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.15 of 100
- Quality
- 69.39
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.44
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Removal of tissue | 12 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 90 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016005538 | IL | MD | Primary Podiatric Medicine Podiatrist |
| 1031-25 | WI | MD | Primary Podiatric Medicine Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Froedtert South, Inc. | Current | Accepting new patients | |
| Froedtert South, Inc. | Past | Accepting new patients | |
| Kenosha Pathology Consultants | Past | Accepting new patients |
Locations
6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300
9697 Saint Catherines Dr
#300
Pleasant Prairie, WI 53158
9697 Saint Catherines Dr
Ste 300
Pleasant Prairie, WI 53158
Phone (262) 577-8320
Interoperability endpoints
- amontemurro341955@direct.froedtert.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Froedtert South Medical Group
- Family Medicine Physician
- Kenosha, WI
- NPI 1558305284
-
- General Acute Care Hospital
- Pleasant Prairie, WI
- NPI 1003831132
-
- Anatomic Pathology & Clinical Pathology Physician
- Kenosha, WI
- NPI 1790812857
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Pleasant Prairie, WI
- NPI 1003831132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1700126562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6308 8TH AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531435031",
"telephone_number": "262-656-3313",
"fax_number": "262-653-5850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9697 SAINT CATHERINES DR STE 300",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531582118",
"telephone_number": "262-656-3338",
"fax_number": "262-656-3368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTEMURRO",
"first_name": "ANTONIO",
"middle_name": "IPPOLITO",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "IL",
"license": "016005538",
"primary": false
},
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "WI",
"license": "1031-25",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700126562",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "K400163324",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pleasant Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.