Individual provider Active NPI

Mary-Kate Dodge Uy, APNP

  • Adult Health Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1871829531
Registry record updated Jan 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3885-033 Issued in WI
Practice address
1840 N Prospect Ave
Milwaukee, WI 53202-1975
Phone
(414) 831-6877
Fax
(414) 831-6765
NPI assigned
Oct 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3885-033 WI Primary

Addresses

Primary practice location

1840 N Prospect Ave
Milwaukee, WI 53202-1975

Mailing address

1840 N Prospect Ave
Milwaukee, WI 53202-1975
Phone (414) 831-6877

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
I20110509000439 WI Practitioner - Nurse Practitioner 8426234436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint John'S Communities, Inc.Group PAC ID 7113917543, 3 clinicians

Practice addresses (Care Compare)

1840 N Prospect Ave
Milwaukee, WI 53202-1975
Phone (414) 831-6876

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3885-033WIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Healthcare Corporation Midwest CurrentSince Apr 1, 2022 Accepting new patients
Saint John'S Communities, Inc. CurrentSince Sep 29, 2017 Accepting new patients
Vitas Healthcare Corporation Midwest CurrentSince Dec 13, 2022 Accepting new patients

Locations

12000 W Park Pl
Ste 200
Milwaukee, WI 53224
Phone (414) 257-2600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610150400000",
    "number": "1871829531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 N PROSPECT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532021975",
            "telephone_number": "414-831-6877",
            "fax_number": "414-831-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 N PROSPECT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532021975",
            "telephone_number": "414-831-6877",
            "fax_number": "414-831-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UY",
        "first_name": "MARY-KATE",
        "middle_name": "DODGE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "3885-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.