NPIMap

Organization Active NPI

Vitas Healthcare Corporation Midwest

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Milwaukee, WI
National Provider Identifier
1730756156
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
VITAS HEALTHCARE CORPORATION MIDWEST
Practice address
12000 W Park PL Ste 200
Milwaukee, WI 53224-3051
Phone
(414) 257-2600
NPI assigned
Jun 4, 2021
Organization subpart
Yes
Parent organization
VITAS HEALTHCARE CORPORATION MIDWESTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Nicholas Westfall
Title
Ceo
Phone
(513) 618-2230

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

12000 W Park PL Ste 200
Milwaukee, WI 53224-3051

Mailing address

3046 Corporate Way
Miramar, FL 33025-6547

Other names 1

  • Milwaukee CBPC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211210000562 WI Part B Supplier - Clinic/Group Practice 3173566213 Receives reassigned benefits from 4 practitioners
Practice locations: Milwaukee, WI

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Vitas Healthcare Corporation Midwest8 organizations share this tax ID, including this one
Part of
Vitas Healthcare Corporation Midwest

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

567 1st St N
Alabaster, AL 35007
Phone (205) 663-3953

1719 Howard St
Evanston, IL 60202
Phone (630) 877-8651

8 Executive Dr
Ste 125B
Fairview Heights, IL 62208
Phone (618) 622-9073

108 E Columbian Blvd S
#B
Litchfield, IL 62056
Phone (618) 622-9073

703 W Union Ave
Ste 1
Litchfield, IL 62056
Phone (618) 622-9073

3209 W Smith Valley Rd
Ste 214
Greenwood, IN 46142
Phone (800) 996-8482

10000 W 75th St
Ste 240
Shawnee Mission, KS 66204
Phone (800) 755-6678

26261 Evergreen Rd
Ste 400
Southfield, MI 48076
Phone (248) 204-6300

26677 W 12 Mile Rd
Ste 102
Southfield, MI 48034
Phone (248) 358-6962

1487 US Highway 61
Ste C
Crystal Cty, MO 63028
Phone (636) 937-2529

4041 S Lynn Ct Dr
Ste 300
Independence, MO 64055
Phone (816) 447-3201

6601 Winchester Ave
Ste 220
Kansas City, MO 64133
Phone (816) 447-3201

2316 E Meyer Blvd
Fl 7
Kansas City, MO 64132
Phone (816) 276-9900

4409 Meramec Bottom Rd
Ste B
Saint Louis, MO 63129
Phone (314) 682-3400

12000 W Park Pl
Ste 200
Milwaukee, WI 53224
Phone (414) 257-2600

331 E Puetz Rd
Ste 107
Oak Creek, WI 53154
Phone (262) 321-3970

2675 N Mayfair Rd
Ste 500
Wauwatosa, WI 53226
Phone (414) 257-2600

8300 W Beloit Rd
Unit 858
West Allis, WI 53219
Phone (414) 607-4452

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1730756156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3046 CORPORATE WAY",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330256547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 W PARK PL STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243051",
            "telephone_number": "414-257-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAS HEALTHCARE CORPORATION MIDWEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VITAS HEALTHCARE CORPORATION MIDWEST",
        "enumeration_date": "2021-06-04",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "WESTFALL",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-618-2230"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Milwaukee CBPC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Milwaukee CBPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.