Individual provider Active NPI

Brady G McIntosh, M.D.

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1841495074
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
63688 Issued in WI
Practice address
9200 W Wisconsin Ave
Emergency Medicine
Milwaukee, WI 53226-3522
Phone
(414) 805-6450
Fax
(414) 805-6464
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11013891A IN
Emergency Medicine Physician 207P00000X 63688 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Emergency Medicine
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Emergency Medicine
Milwaukee, WI 53226-3522
Phone (414) 805-6450

Other identifiers 1

IdentifierTypeStateIssuer
1841495074MedicaidWI

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
I20150415002419 WI Practitioner - Emergency Medicine 9830227586 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

201 N Mayfair Rd
Wauwatosa, WI 53226-4216
Phone (414) 259-7200

3237 S 16TH St
Milwaukee, WI 53215-4526
Phone (414) 647-5000

3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4011

3807 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-8173

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000

Hospital & facility affiliations

  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
  • Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11013891AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 1, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
Integrated Therapeutic Massage LLC PastSince Aug 1, 2021 Accepting new patients
Icem, LLC Emergency Medicine Past Accepting new patients

Locations

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

375 W River Woods Pkwy
Glendale, WI 53212
Phone (414) 326-1500

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

3237 S 16th St
Milwaukee, WI 53215
Phone (414) 647-5000

2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

4805 S Moorland Rd
New Berlin, WI 53151
Phone (262) 798-7200

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

10625 W North Ave
Ste 102
Wauwatosa, WI 53226
Phone (414) 877-5350

201 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 259-7200

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

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 and National Provider Directory roles.

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1841495074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "EMERGENCY MEDICINE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "EMERGENCY MEDICINE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "BRADY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "11013891A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "63688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841495074",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.