Individual provider Active NPI

Samuel Isaac Frost, D.O.

  • Diagnostic Radiology Physician
  • Wauwatosa, WI
National Provider Identifier
1861704223
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
56969 Issued in WI
Practice address
4025 N 92ND St
Wauwatosa, WI 53222-1613
Phone
(608) 213-6295
NPI assigned
Jul 13, 2010
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036147654 IL
Diagnostic Radiology Physician 2085R0202X 56969 WI Primary

Addresses

Primary practice location

4025 N 92ND St
Wauwatosa, WI 53222-1613

Mailing address

4025 N 92ND St
Wauwatosa, WI 53222-1613
Phone (414) 358-5437

Other practice location 1

45 Tower Ct Ste C
Gurnee, IL 60031-3376
Phone (847) 623-3200

Other identifiers 1

IdentifierTypeStateIssuer
1861704223MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sfrost177728@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address sfrost177728@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150515001326 WI Practitioner - Diagnostic Radiology 6002136983 Reassigns benefits to 3 organizations
I20190108000188 IL Practitioner - Diagnostic Radiology 6002136983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Amg Illinois LTDGroup PAC ID 8527117027, 24 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 489-9000

7505 Grand Ave
Gurnee, IL 60031-1551
Phone (847) 245-8448

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56969WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Jul 11, 2016 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jul 11, 2016 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 11, 2016 Accepting new patients
Aurora Medical Group, Inc. Diagnostic Radiology CurrentSince Jul 11, 2016 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jul 11, 2016 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2015 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 7, 2023 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jul 1, 2015 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Amg Illinois LTD CurrentSince Nov 21, 2018 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jul 7, 2023 Accepting new patients
Amg Illinois LTD CurrentSince Nov 21, 2018 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

45 Tower Ct
Gurnee, IL 60031
Phone (847) 623-3200

45 Tower Ct
#C
Gurnee, IL 60031
Phone (847) 623-3200

7505 Grand Ave
Gurnee, IL 60031
Phone (847) 245-8448

112 N US Highway 141
Crivitz, WI 54114
Phone (715) 735-6621

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

202 S Park St
Madison, WI 53715
Phone (608) 267-6000

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

3003 University Dr
Marinette, WI 54143
Phone (715) 732-8200

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

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

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

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

4025 N 92nd St
Wauwatosa, WI 53222
Phone (414) 358-5431

Interoperability endpoints

  • Direct secure messaging: sfrost177728@direct.myadvocateaurora.org

Organizations & group practices 12

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 7

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1861704223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N 92ND ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221613",
            "telephone_number": "414-358-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 N 92ND ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221613",
            "telephone_number": "608-213-6295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Tower Ct Ste C",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600313376",
            "country_code": "US",
            "telephone_number": "847-623-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FROST",
        "first_name": "SAMUEL",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036147654",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "56969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861704223",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfrost177728@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4025 N 92nd St",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532221613",
            "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": "4025 N 92nd St",
            "city": "Wauwatosa",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532221613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfrost177728@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "45 Tower Ct Ste C",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600313376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.