Individual provider Active NPI

Maureen T Blaha, APNP

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1821541186
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7153 Issued in WI
Practice address
2901 W Kinnickinnic River Pkwy
Suite 315
Milwaukee, WI 53215-3677
Phone
(414) 649-5646
Fax
(414) 649-6282
NPI assigned
Aug 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7153 WI Primary

Addresses

Primary practice location

2901 W Kinnickinnic River Pkwy
Suite 315
Milwaukee, WI 53215-3677

Mailing address

2810 N 72ND St
Milwaukee, WI 53210-1105
Phone (414) 442-4872

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mblaha141595@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
I20160915000618 WI Practitioner - Nurse Practitioner 5092001107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc. 3,764 clinicians

Practice addresses (Care Compare)

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 22, 2016 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 22, 2016 Accepting new patients
Comprehensive Cardiovascular Care, LLP Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2901 W Kinnickinnic River Pkwy
Ste 315
Milwaukee, WI 53215
Phone (414) 385-2590

Interoperability endpoints

  • Direct secure messaging: mblaha141595@direct.myadvocateaurora.org

Organizations & group practices 5

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 2

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": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1821541186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 N 72ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101105",
            "telephone_number": "414-442-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY",
            "address_2": "SUITE 315",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153677",
            "telephone_number": "414-649-5646",
            "fax_number": "414-649-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAHA",
        "first_name": "MAUREEN",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mblaha141595@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2901 W Kinnickinnic River Pkwy",
            "address_2": "Suite 315",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153677",
            "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": "2901 W Kinnickinnic River Pkwy",
            "address_2": "Suite 315",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.