Individual provider Active NPI

Philip G Conrardy, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Milwaukee, WI
National Provider Identifier
1780667683
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
30724-20 Issued in WI
Practice address
7620 W Burleigh St
Milwaukee, WI 53222-5002
Phone
(414) 444-6000
Fax
(888) 664-5360
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036124777 IL
Anesthesiology Physician 207L00000X 37204-020 WI
Pain Medicine (Anesthesiology) Physician 207LP2900X 30724-20 WI Primary

Addresses

Primary practice location

7620 W Burleigh St
Milwaukee, WI 53222-5002

Mailing address

7620 W Burleigh St
Milwaukee, WI 53222-5002
Phone (414) 444-6000

Other identifiers 2

IdentifierTypeStateIssuer
050059549OtherRAIL ROAD MEDICARE
31916700MedicaidWI

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
I20040519000942 WI Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 2860392685 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

125 Hospital Dr
Watertown, WI 53098-3303
Phone (920) 262-4449

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37204-020WIMDAnesthesiology Physician
30724-20WIMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Eagle River Hospital & Clinics, Inc. CurrentSince Mar 11, 2017 Accepting new patients
Aspirus Eagle River Hospital, Inc. CurrentSince Mar 11, 2017 Accepting new patients
Watertown Physician Practices LLC Current Accepting new patients
Watertown Physician Practices LLC CurrentSince Apr 1, 2023 Accepting new patients
Watertown Physician Practices LLC CurrentSince Apr 1, 2023 Accepting new patients
Southeastern Wisconsin Anesthesiology, S.C. Anesthesiology Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Interoperability endpoints

  • Direct secure messaging: philip.conrardy.1@17022.direct.athenahealth.com

Organizations & group practices 8

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1780667683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532225002",
            "telephone_number": "414-444-6000",
            "fax_number": "888-664-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532225002",
            "telephone_number": "414-444-6000",
            "fax_number": "888-664-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRARDY",
        "first_name": "PHILIP",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036124777",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "37204-020",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WI",
            "license": "30724-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "050059549",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31916700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.