Madeline M Pereira, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Ripon, WI

NPI 1912936576 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1912936576
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
91626-30 (WI)
Practice address
933 Newbury St
Ripon, WI 54971-1730
Phone
(920) 748-3101
Fax
(920) 406-7675
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare Care Compare profile

Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners Services SC (37 clinicians)

Practice addresses (Care Compare)

2801 W Kinnickinnic River Pkwy
Suite 1080
Milwaukee, WI 53215-3689
Phone (414) 908-6500

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WI, CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040504001445 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163410598 Reassigns benefits to 1 organization
I20120718000535 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163410598 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
48622WIMDClinical Pathology/Laboratory Medicine Physician
2650CAMDClinical Nurse Specialist
91626-30WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Partners Services, S.C. Current
since Feb 10, 2022
Accepting new patients
Gazzz Group SC Nurse Anesthetist, Certified Registered Past
since Jun 1, 2006
Accepting new patients
Southeastern Wisconsin Anesthesiology, S.C. Past Accepting new patients

Locations

2801 W Kinnickinnic River Pkwy
Ste 1030
Milwaukee, WI 53215
Phone (414) 649-5200

2801 W Kinnickinnic River Pkwy
Ste 1080
Milwaukee, WI 53215
Phone (414) 908-6506

88948 Box
Milwaukee, WI 53288

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 91626-30 WI Yes

Addresses

Primary practice location

933 Newbury St
Ripon, WI 54971-1730

Mailing address

200 E Washington St
P O Box 8031
Appleton, WI 54911-5490
Phone (888) 883-8533

Other identifiers

IdentifierTypeStateIssuer
44306900MedicaidWI

Other names

  • Madeline M Machi Former name

Other providers in Ripon, WI

All providers in Ripon, WI · Certified Registered Nurse Anesthetist in Wisconsin

Sources for this page

Verify at the official NPI Registry.