Individual provider Active NPI

Michael Allen Brewer, DO

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1780945857
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64371 Issued in WI
Practice address
3056 S Kinnickinnic Ave
Milwaukee, WI 53207-2583
Phone
(414) 769-4900
Fax
(414) 769-4910
NPI assigned
Jun 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 64371 WI Primary

Addresses

Primary practice location

3056 S Kinnickinnic Ave
Milwaukee, WI 53207-2583

Mailing address

4425 N Port Washington Rd
Glendale, WI 53212-1082
Phone (414) 326-2218

Other practice location 1

1121 E North Ave
Milwaukee, WI 53212-3515
Phone (414) 267-6502

Other identifiers 1

IdentifierTypeStateIssuer
1780945857MedicaidWI

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
I20150715000650 WI Practitioner - Family Practice 7113143553 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

3237 S 16TH St
Milwaukee, WI 53215-4526
Phone (414) 647-5069

Hospital & facility affiliations

  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64371WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine Current Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Family Medicine CurrentSince May 26, 2020 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Aug 10, 2015 Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Aug 10, 2015 Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

3237 S 16th St
Milwaukee, WI 53215
Phone (414) 647-5000

3056 S Kinnickinnic Ave
Milwaukee, WI 53207
Phone (414) 769-4900

1121 E North Ave
Milwaukee, WI 53212
Phone (414) 267-6500

3056 S Kinnickinnic Ave
Ste 300
Milwaukee, WI 53207
Phone (414) 294-0971

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 5

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1780945857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-326-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 S KINNICKINNIC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532072583",
            "telephone_number": "414-769-4900",
            "fax_number": "414-769-4910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 E North Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532123515",
            "country_code": "US",
            "telephone_number": "414-267-6502",
            "fax_number": "414-267-3892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWER",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "64371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780945857",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.