Individual provider Active NPI

Lucas Grover, MD

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1790212819
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
72925-20 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-6450
Fax
(414) 805-6464
NPI assigned
May 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 72925-20 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6450

Other practice location 1

8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 955-4575

Other practice location 2

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

Other practice location 3

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7200

Other practice location 4

W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

Other identifiers 1

IdentifierTypeStateIssuer
1790212819MedicaidWI

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
I20200414003383 WI Practitioner - Emergency Medicine 1658641428 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72925-20WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upland Hills Health, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Upland Hills Health, Inc Emergency Medicine CurrentSince Dec 1, 2025 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Apr 18, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
Prairie Ridge Health Inc. CurrentSince Nov 1, 2025 Accepting new patients
Madison Emergency Physicians, SC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
The Medical College of Wisconsin, Inc. Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients

Locations

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

4805 S Moorland Rd
New Berlin, WI 53151
Phone (262) 798-7200

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

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

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: lgrover391136@direct.froedtert.com
  • Direct secure messaging: lgrover437806@direct-ehr-ssmhc.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1790212819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 W Watertown Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263548",
            "country_code": "US",
            "telephone_number": "414-955-4575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530959274",
            "country_code": "US",
            "telephone_number": "262-836-7300",
            "fax_number": "262-836-7301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4805 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517401",
            "country_code": "US",
            "telephone_number": "262-798-7200",
            "fax_number": "262-798-7271",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W180N8085 Town Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-251-1000",
            "fax_number": "262-518-5052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVER",
        "first_name": "LUCAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-19",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "72925-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790212819",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.