Individual provider Active NPI

Michael C Groeschel, PA

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1881642445
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1913-023 Issued in WI
Practice address
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone
(414) 649-6588
Fax
(770) 237-1723
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1913-023 WI Primary

Addresses

Primary practice location

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330

Mailing address

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6588

Other identifiers 1

IdentifierTypeStateIssuer
001OtherWIBCBS

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
I20051115000672 WI Practitioner - Physician Assistant 2365461761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Marquette University School of Dentistry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, shared by 20 NPIs, 1,107 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, shared by 42 NPIs, 3,764 clinicians

Practice addresses (Care Compare)

14555 W National Ave
Suite 120
New Berlin, WI 53151-4494
Phone (262) 827-2955

1575 N Rivercenter Dr
Milwaukee, WI 53212-3978
Phone (414) 283-8444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1913-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Radiologists LTD Current Accepting new patients
Aurora Advanced Healthcare Inc PastSince Jun 15, 2026 Accepting new patients

Locations

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

14555 W National Ave
Ste 120
New Berlin, WI 53151
Phone (262) 827-2955

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.

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1881642445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-649-6588",
            "fax_number": "770-237-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-649-6588",
            "fax_number": "770-237-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROESCHEL",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1913-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.