Individual provider Active NPI

Mark J. Salisz, PA

  • Physician Assistant
  • Germantown, WI
National Provider Identifier
1801158704
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2938 Issued in WI
Practice address
W180N11070 River LN
Germantown, WI 53022-3109
Phone
(262) 532-9700
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2938 WI Primary

Addresses

Primary practice location

W180N11070 River LN
Germantown, WI 53022-3109

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 532-9700

Other practice location 1

N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810
Phone (262) 251-7500

Other identifiers 1

IdentifierTypeStateIssuer
100023716MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address msalisz21937@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120731000200 WI Practitioner - Physician Assistant 0143486548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

W180N11070 River LN
Germantown, WI 53022-3109
Phone (262) 532-9700

Hospital & facility affiliations

  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2938WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Jul 16, 2012 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jul 16, 2012 Accepting new patients

Locations

W180N11070 River Ln
Germantown, WI 53022
Phone (262) 532-9700

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

975 Port Washington Rd
Ste 110
Grafton, WI 53024
Phone (262) 329-1000

1640 E Sumner St
Hartford, WI 53027
Phone (262) 670-4000

N84W16889 Menomonee Ave
Menomonee Fls, WI 53051
Phone (262) 251-7500

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

205 Valley Ave
West Bend, WI 53095
Phone (262) 338-1123

Interoperability endpoints

  • Direct secure messaging: msalisz21937@direct.myadvocateaurora.org

Organizations & group practices 2

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1801158704",
    "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": "262-532-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W180N11070 RIVER LN",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223109",
            "telephone_number": "262-532-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N84W16889 Menomonee Ave",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530512810",
            "country_code": "US",
            "telephone_number": "262-251-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALISZ",
        "first_name": "MARK",
        "middle_name": "J.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100023716",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msalisz21937@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "N84W16889 Menomonee Ave",
            "city": "Menomonee Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530512810",
            "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": "N84W16889 Menomonee Ave",
            "city": "Menomonee Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530512810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

Verify at the official NPI Registry.