Individual provider Active NPI

Paul O'Neill, M.D.

  • Internal Medicine Physician
  • Waukesha, WI
National Provider Identifier
1821062225
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33540 Issued in WI
Practice address
N14W23900 Stone Ridge Dr
Prohealth Care Medical Assoicates Inc.
Waukesha, WI 53188-1135
Phone
(262) 549-3030
NPI assigned
Feb 14, 2006
Last updated
Apr 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33540 WI Primary
Pediatrics Physician 208000000X 33540 WI

Addresses

Primary practice location

N14W23900 Stone Ridge Dr
Prohealth Care Medical Assoicates Inc.
Waukesha, WI 53188-1135

Mailing address

N14W23900 Stone Ridge Dr
Prohealth Care Medical Assoicates Inc.
Waukesha, WI 53188-1135
Phone (262) 549-3030

Other identifiers 1

IdentifierTypeStateIssuer
31842000MedicaidWI

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
I20100215000752 WI Practitioner - Pediatric MedicinePractitioner - Internal Medicine 8022920685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Wayne State University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-1000

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33540WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. Internal Medicine CurrentSince Aug 17, 1992 Accepting new patients
Prohealth Medical Group Inc Internal Medicine CurrentSince Aug 17, 1992 Accepting new patients
Prohealth Medical Group Inc Internal Medicine Past Accepting new patients

Locations

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: poneill10526@direct.phci.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1821062225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N14W23900 STONE RIDGE DR",
            "address_2": "PROHEALTH CARE MEDICAL ASSOICATES INC.",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881135",
            "telephone_number": "262-549-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23900 STONE RIDGE DR",
            "address_2": "PROHEALTH CARE MEDICAL ASSOICATES INC.",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881135",
            "telephone_number": "262-549-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "33540",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "33540",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31842000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.