Individual provider Active NPI

Michael Maher, PA-C

  • Surgical Physician Assistant
  • Pleasant Prairie, WI
National Provider Identifier
1811776669
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
7641-23 Issued in WI
Practice address
9697 Saint Catherines Dr # 200
Pleasant Prairie, WI 53158-2118
Phone
(262) 577-8000
NPI assigned
Sep 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 7641-23 WI Primary

Addresses

Primary practice location

9697 Saint Catherines Dr # 200
Pleasant Prairie, WI 53158-2118

Mailing address

17425 Summit View Place LN
Wildwood, MO 63038-2106
Phone (314) 707-2504

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
I20231006003048 WI Practitioner - Physician Assistant 0941655112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

6308 8TH Ave
Kenosha, WI 53143-5031
Phone (262) 771-0073

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8300

9697 Saint Catherines Dr
Pleasant Prairie, WI 53158-2118
Phone (262) 656-3590

Hospital & facility affiliations

  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. CurrentSince Oct 30, 2023 Accepting new patients

Locations

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

9697 Saint Catherines Dr
#200
Pleasant Prairie, WI 53158
Phone (262) 577-8000

9697 Saint Catherines Dr
Ste 200
Pleasant Prairie, WI 53158
Phone (262) 656-3590

Interoperability endpoints

  • Direct secure messaging: mmaher691027@direct.froedtert.com

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 1

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": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1811776669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17425 SUMMIT VIEW PLACE LN",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630382106",
            "telephone_number": "314-707-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9697 SAINT CATHERINES DR # 200",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582118",
            "telephone_number": "262-577-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "7641-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.