Individual provider Active NPI

Joseph Mark Schmidt, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Waukesha, WI
National Provider Identifier
1912014697
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3968 Issued in WI
Practice address
1111 Delafield St
Suite 222
Waukesha, WI 53188-3417
Phone
(262) 547-8665
Fax
(262) 547-4328
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3968 WI Primary

Addresses

Primary practice location

1111 Delafield St
Suite 222
Waukesha, WI 53188-3417

Mailing address

1111 Delafield St
Suite 222
Waukesha, WI 53188-3417
Phone (262) 547-8665

Other identifiers 1

IdentifierTypeStateIssuer
33699100MedicaidWI

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
I20050726000079 WI Practitioner - Maxillofacial Surgery 7214964295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Marquette University School of Dentistry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Delafield St
Suite 222
Waukesha, WI 53188-3403
Phone (262) 547-8665

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3968WIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral and Maxillofacial Surgery Associates of Waukesha, LTD. Oral and Maxillofacial Surgery CurrentSince Jul 15, 1991 Accepting new patients
Prohealth Aligned LLC PastSince Apr 18, 2018 Accepting new patients

Locations

39 S 3rd St W
Fort Atkinson, WI 53538
Phone (920) 563-7321

475 Hartwig Blvd
Ste 100
Johnson Creek, WI 53038
Phone (920) 699-3730

320 Bay View Rd
Mukwonago, WI 53149
Phone (262) 368-2980

100 E Commerce Blvd
Ste B
Slinger, WI 53086
Phone (262) 222-5599

1111 Delafield St
Ste 222
Waukesha, WI 53188
Phone (262) 547-8665

Organizations & group practices 2

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1912014697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "SUITE 222",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883417",
            "telephone_number": "262-547-8665",
            "fax_number": "262-547-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "SUITE 222",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883417",
            "telephone_number": "262-547-8665",
            "fax_number": "262-547-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "JOSEPH",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "3968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33699100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.