Active NPI
Donald J Hennessy, M.D.
- Internal Medicine Physician
- Cedarburg, WI
National Provider Identifier
1811960495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 23781
- Practice address
- N143W6515 Pioneer Rd
Cedarburg, WI 53012-2705 - Phone
- (262) 377-6933
- Fax
- (262) 376-2495
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 23781 | WI | Primary |
Addresses
Primary practice location
N143W6515 Pioneer Rd
Cedarburg, WI 53012-2705
Mailing address
N143W6515 Pioneer Rd
Cedarburg, WI 53012-2705
Phone (262) 377-6933
Other practice location 1
W180N7950 Town Hall Rd
Menomonee Falls, WI 53051-4049
Phone (262) 255-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30630400 | Medicaid | WI |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current | Accepting new patients | |
| Prohealth Medical Group Inc. | Internal Medicine | Past | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Internal Medicine | Past | Accepting new patients |
Locations
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516060800000",
"number": "1811960495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N143W6515 PIONEER RD",
"city": "CEDARBURG",
"state": "WI",
"postal_code": "530122705",
"telephone_number": "262-377-6933",
"fax_number": "262-376-2495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N143W6515 PIONEER RD",
"city": "CEDARBURG",
"state": "WI",
"postal_code": "530122705",
"telephone_number": "262-377-6933",
"fax_number": "262-376-2495"
}
],
"practiceLocations": [
{
"address_1": "W180N7950 Town Hall Rd",
"address_purpose": "LOCATION",
"city": "Menomonee Falls",
"state": "WI",
"postal_code": "530514049",
"country_code": "US",
"telephone_number": "262-255-2500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENNESSY",
"first_name": "DONALD",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2018-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "23781",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30630400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cedarburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.