Individual provider Active NPI

Mary C Fox, MD

  • Otolaryngology Physician
  • Waukesha, WI
National Provider Identifier
1770558462
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
37998 Issued in WI
Practice address
1111 Delafield St
Suite1
Waukesha, WI 53188-3417
Phone
(262) 547-1614
Fax
(262) 547-0192
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 37998 WI Primary

Addresses

Primary practice location

1111 Delafield St
Suite1
Waukesha, WI 53188-3417

Mailing address

1111 Delafield St
Suite1
Waukesha, WI 53188-3417
Phone (262) 547-1614

Other identifiers 1

IdentifierTypeStateIssuer
34012700MedicaidWI

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100618000796 WI Practitioner - Otolaryngology 9638140213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Medical College of Wisconsin, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moreland Ear Nose and Throat Group LTDGroup PAC ID 4284605494, 13 clinicians

Practice addresses (Care Compare)

1111 Delafield St
Suite 102
Waukesha, WI 53188-3402
Phone (262) 547-1614

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37998WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moreland Ear Nose & Throat Group LTD CurrentSince Nov 10, 2015 Accepting new patients

Locations

1185 Corporate Center Dr
Ste 205
Oconomowoc, WI 53066
Phone (262) 560-0760

1111 Delafield St
Ste 102
Waukesha, WI 53188
Phone (262) 547-1614

1111 Delafield St
Ste 100
Waukesha, WI 53188
Phone (262) 928-4300

Interoperability endpoints

  • Direct secure messaging: mfox10761@direct.phci.org

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1770558462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "SUITE1",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883417",
            "telephone_number": "262-547-1614",
            "fax_number": "262-547-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "SUITE1",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883417",
            "telephone_number": "262-547-1614",
            "fax_number": "262-547-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "MARY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "37998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34012700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.