Active NPI
Elise Coury Mossallati, APRN
- Nurse Practitioner
- Brown Deer, WI
National Provider Identifier
1841436987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 7486
- Practice address
- 9233 N Green Bay Rd
Brown Deer, WI 53209-1103 - Phone
- (414) 270-8150
- Fax
- (414) 270-8160
- NPI assigned
- Dec 19, 2008
- Last updated
- Jul 21, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 7486 | WI | Primary |
Addresses
Primary practice location
9233 N Green Bay Rd
Brown Deer, WI 53209-1103
Mailing address
9233 N Green Bay Rd
Brown Deer, WI 53209-1103
Phone (414) 270-8150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810017214 | Medicaid | WV |
Other names 1
- Elise Mary Coury-Mossallati
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7486 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart Rehabilitation Institute, Inc | Past | Accepting new patients | |
| United Hospital Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Ascension Sacred Heart Rehabilitation Hospital
- Physical Medicine & Rehabilitation Physician
- Milwaukee, WI
- NPI 1225075203
-
- Internal Medicine Physician
- Bridgeport, WV
- NPI 1760965586
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1841436987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9233 N GREEN BAY RD",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "532091103",
"telephone_number": "414-270-8150",
"fax_number": "414-270-8160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9233 N GREEN BAY RD",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "532091103",
"telephone_number": "414-270-8150",
"fax_number": "414-270-8160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSSALLATI",
"first_name": "ELISE",
"middle_name": "COURY",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-19",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "7486",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810017214",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELISE",
"last_name": "COURY-MOSSALLATI",
"middle_name": "MARY",
"credential": "FNP",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Brown Deer, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.