Individual provider Active NPI

Michael D Becker, MD

  • Cardiovascular Disease Physician
  • Wauwatosa, WI
National Provider Identifier
1811927726
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD60556181 Issued in WA
Practice address
1233 N Mayfair Rd
Suite 201
Wauwatosa, WI 53226-3255
Phone
(414) 774-6300
NPI assigned
Jul 4, 2006
Last updated
Jul 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60556181 WA
Cardiovascular Disease Physician 207RC0000X 23554-020 WI
Cardiovascular Disease Physician 207RC0000X MD60556181 WA Primary
Nuclear Cardiology Physician 207UN0901X 23554-020 WI

Addresses

Primary practice location

1233 N Mayfair Rd
Suite 201
Wauwatosa, WI 53226-3255

Mailing address

4555 W Schroeder Dr
Suite 170
Milwaukee, WI 53223-1475
Phone (414) 365-3210

Other practice location 1

1211 Skyview Dr
Aberdeen, WA 98520-1099
Phone (360) 533-9830

Other identifiers 2

IdentifierTypeStateIssuer
2042975MedicaidWA
30487600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150423001306 ID Practitioner - Cardiovascular Disease (Cardiology) 8921076589
I20161003000518 WA Practitioner - Cardiovascular Disease (Cardiology) 8921076589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehoboth McKinley Christian Health Care Services, Inc.Group PAC ID 1759293855, shared by 3 NPIs, 31 clinicians

Practice addresses (Care Compare)

1900 Red Rock Dr
Gallup, NM 87301-5682
Phone (505) 863-1820

1910 Red Rock Dr
Gallup, NM 87301-5682
Phone (505) 863-7136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23554-020WIMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor Community Hospital CurrentSince May 13, 2019 Accepting new patients
GHCH Physician Services, LLC Internal Medicine CurrentSince May 13, 2019 Accepting new patients
Midwest Area Physicians, LLC Cardiovascular Disease Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Cardiovascular Associates of Wisconsin, LLP Cardiovascular Disease Past Accepting new patients

Locations

1211 Skyview Dr
Aberdeen, WA 98520
Phone (360) 532-3808

319 E Pioneer Ave
Montesano, WA 98563
Phone (360) 249-1980

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1811927726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 W SCHROEDER DR",
            "address_2": "SUITE 170",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532231475",
            "telephone_number": "414-365-3210",
            "fax_number": "414-365-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 N MAYFAIR RD",
            "address_2": "SUITE 201",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263255",
            "telephone_number": "414-774-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Skyview Dr",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "WA",
            "postal_code": "985201099",
            "country_code": "US",
            "telephone_number": "360-533-9830",
            "fax_number": "360-533-8398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKER",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60556181",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "23554-020",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD60556181",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "WI",
            "license": "23554-020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042975",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30487600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.