Mala Thenappan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

36822-020 Issued in WI

Practice address

3070 N 51St St
Suite 100
Milwaukee, WI 53210-1645

Phone

(414) 875-9950

Fax

(414) 447-2575

NPI assigned

May 23, 2006

Last updated

Apr 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

General Surgery

Education

Medical College of Wisconsin, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Walworth Hospital & Medical Center Hospital, Lake Geneva, WI, CCN 521357

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mercy Health System Corporation

  dba MHS Physician Services

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment NPD
• Mercy Health System Corporation

  dba Mercy Walworth Hospital and Medical Center

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  Medicare reassignment NPD
• Watertown Physician Practices LLC

  • Family Medicine Physician
  • Watertown, WI
  • NPI 1770964363
  Medicare reassignment NPD
• Mala Thenappan, MD

  • Surgery Physician
  • Milwaukee, WI
  • NPI 1588619134
  NPD (past) Authorized official
• Mercy Health System Corporation

  dba Mercy Hospital Janesville

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD
• Watertown Physician Practices LLC

  • Obstetrics & Gynecology Physician
  • Watertown, WI
  • NPI 1225412265
  NPD
• Advanced Healthcare SC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1154371847

  Surgery

  NPD (past)
• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133

  Surgery

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health System Corporation

  dba Mercy Walworth Hospital and Medical Center

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1861447427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N 51ST ST",
            "address_2": "SUITE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101645",
            "telephone_number": "414-875-9950",
            "fax_number": "414-447-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N 51ST ST",
            "address_2": "SUITE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101645",
            "telephone_number": "414-875-9950",
            "fax_number": "414-447-2575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N2950 State Road 67",
            "address_purpose": "LOCATION",
            "city": "Lake Geneva",
            "state": "WI",
            "postal_code": "531472655",
            "country_code": "US",
            "telephone_number": "262-245-0535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THENAPPAN",
        "first_name": "MALA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "36822-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32430500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary L Theisen, NP
• Thekey of Wisconsin, LLC
• Leslie Elizabeth Thelan, MD
• Anne Thelen
• Robert Joseph Themmes, APSW
• Jillian Lee Theobald, MD PHD
• Kelly Theodore, PMHNP, FNP
• Rachel Esther Theofanis, CCC-SLP
• Elizabeth L Theppanya, APNP
• Thera-Dynamics, S.C.

• Surgery Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.