Active NPI
Procare Medical Group SC
- Multi-Specialty Clinic/Center
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- PROCARE MEDICAL GROUP SC
- Practice address
- 3727 W Wisconsin Ave
Milwaukee, WI 53208-3182 - Phone
- (414) 291-2626
- Fax
- (414) 291-2630
- NPI assigned
- Dec 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rosalina Valle
- Title
- Office Manager
- Phone
- (414) 291-2624
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | WI | Primary |
Addresses
Primary practice location
3727 W Wisconsin Ave
Milwaukee, WI 53208-3182
Mailing address
3727 W Wisconsin Ave
Milwaukee, WI 53208-3182
Phone (414) 291-2626
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32808100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040702000975 | WI | Part B Supplier - Clinic/Group Practice | 0840277265 |
Receives reassigned benefits from 19 practitioners Practice locations: Milwaukee, WI; West Allis, WI |
National Provider Directory
National Provider DirectoryLocations
2350 W Villard Ave
Ste 311
Milwaukee, WI 53209
Phone (414) 464-2424
1532 W Becher St
Milwaukee, WI 53215
Phone (414) 763-9240
1308 W Lincoln Ave
Milwaukee, WI 53215
Phone (414) 645-7499
613 N 36th St
Unit 500
Milwaukee, WI 53208
Phone (414) 291-2626
1502 S Layton Blvd
Milwaukee, WI 53215
Phone (414) 246-7024
3510 W Burnham St
Milwaukee, WI 53215
Phone (414) 342-8300
932 S 60th St
West Allis, WI 53214
Phone (414) 291-2626
5631 W Lincoln Ave
West Allis, WI 53219
Phone (414) 645-7499
Interoperability endpoints
- https://api.platform.athenahealth.com/18762/brand/1/csg/1/fhir/r4
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Urgent Care Clinic/Center
- Milwaukee, WI
- NPI 1194083410
Practitioners & affiliated clinicians
Practitioners 23
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1632355200000",
"number": "1922164656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3727 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083182",
"telephone_number": "414-291-2626",
"fax_number": "414-291-2630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3727 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083182",
"telephone_number": "414-291-2626",
"fax_number": "414-291-2630"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROCARE MEDICAL GROUP SC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-28",
"last_updated": "2021-09-23",
"certification_date": "2021-09-23",
"status": "A",
"authorized_official_last_name": "VALLE",
"authorized_official_first_name": "ROSALINA",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "414-291-2624"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32808100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.