Ahmad S Khraisat, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

43201 Issued in WI

Practice address

4448 W Loomis Rd
Greenfield, WI 53220-4800

Phone

(414) 817-0784

Fax

(414) 817-0787

NPI assigned

Aug 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

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

Specialty

Interventional Cardiology

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

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

Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
• West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139
• Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akhraisat20777@direct.myadvocateaurora.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.

• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment Care Compare group NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • Saint Francis, WI
  • NPI 1003861188
  Medicare reassignment Care Compare group NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  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
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

• Ascension SE Wisconsin Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Aurora Health Care Metro, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cudahy, WI
  • NPI 1235355983

  Hospital

  Care Compare affiliation
• Aurora Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  Care Compare affiliation
• Aurora Health Care Southern Lakes, Inc.

  • General Acute Care Hospital
  • Kenosha, WI
  • NPI 1225156888
  Care Compare affiliation
• West Allis Memorial Hospital, Inc.

  • Clinic/Center
  • West Allis, WI
  • NPI 1235345695

  Hospital

  Care Compare affiliation
• West Allis Memorial Hospital, Inc.

  • General Acute Care Hospital
  • West Allis, WI
  • NPI 1407801640
  Care Compare affiliation

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1750375143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4448 W LOOMIS RD",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204800",
            "telephone_number": "414-817-0784",
            "fax_number": "414-817-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHRAISAT",
        "first_name": "AHMAD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "43201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100012862",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750375143",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akhraisat20777@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2000 E Layton Ave",
            "city": "Saint Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356053",
            "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": "2000 E Layton Ave",
            "city": "Saint Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tara Kenyon, MS
• Ashley Kerman
• Kerwin Chiropractic, SC
• Kenneth J Kerwin, D.C.
• Nicholas Ketchum, M.D.
• Kara Grace Kibitlewski, SLP
• Monalisa Killerbrew
• Min Kim
• Kristine Jean Kimmler, MSPT
• Kindred Transitional Care and Rehab Milwaukee

• Interventional Cardiology Physician in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Interventional Cardiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.