Active NPI
Kelly Donnelly Mueller, D.O.
- Neurology Physician
- Sheboygan, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 22300-875
- Practice address
- 2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129 - Phone
- (920) 457-4461
- NPI assigned
- Jun 12, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 268837 | NY | |
| Neurology Physician | 2084N0400X | 22300-875 | WI | Primary |
Addresses
Primary practice location
2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Mailing address
47 New Scotland Ave # MC70
Albany, NY 12208-3412
Other practice location 1
47 New Scotland Ave
Preliminary Medicine (Neurology)
Albany, NY 12208-3412
Phone (518) 262-3125
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100199202 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | kdonnellymueller340391@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Philadelphia College of Osteopathic Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 268837 | NY | MD | Neurology Physician |
| 22300-875 | WI | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Baycare Aurora, LLC | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| U S Health Dept of Health & Human Services | Current | Accepting new patients | |
| U S Health Dept of Health & Human Services | Current | Accepting new patients | |
| Albany Medical College | Neurology | Current | Accepting new patients |
| Albany Medical College | Neurology | Current | Accepting new patients |
| Albany Medical College | Current | Accepting new patients | |
| Albany Medical College | Current | Accepting new patients | |
| Eagle Butte Indian Health Service Hospital | Current | Accepting new patients | |
| US Health Dept of Health & Human Services | Current | Accepting new patients | |
| Albany Medical College | Current | Accepting new patients | |
| Albany Medical College | Past | Accepting new patients | |
| U S Health Dept of Health & Human Services | Past | Accepting new patients | |
| U S Health Dept of Health & Human Services | Past | Accepting new patients |
Locations
669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100
453 Pine Grove Rd
Hays, MT 59527
Phone (406) 353-3190
47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773
47 New Scotland Ave
#70
Albany, NY 12208
Phone (518) 262-5226
1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705
2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461
Interoperability endpoints
- kdonnellymueller24105@albanymed.direct-ci.com
- kdonnellymueller340391@direct.myadvocateaurora.org
Organizations & group practices 16
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.
-
- Public Health or Welfare Agency
- Eagle Butte, SD
- NPI 1558395848
TX
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1255387726
-
dba Albany Med EmUrgent Care
- Urgent Care Clinic/Center
- Albany, NY
- NPI 1386038925
-
dba Albany Medical College Department of Medicine
- Allergy & Immunology Physician
- Albany, NY
- NPI 1386689248
-
dba Albany Medical College Dept of PM&R
- Physical Medicine & Rehabilitation Physician
- Albany, NY
- NPI 1629008537
-
dba Albany Medical College Dept of Neurology
- Neurology Physician
- Albany, NY
- NPI 1811921786
-
dba Eagle Child Health Center
- Critical Access Hospital Clinic/Center
- Hays, MT
- NPI 1174660245
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1932369923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 NEW SCOTLAND AVE # MC70",
"city": "ALBANY",
"state": "NY",
"postal_code": "122083412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2414 KOHLER MEMORIAL DR",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530813129",
"telephone_number": "920-457-4461"
}
],
"practiceLocations": [
{
"address_1": "47 New Scotland Ave",
"address_2": "Preliminary Medicine (Neurology)",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122083412",
"country_code": "US",
"telephone_number": "518-262-3125",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DONNELLY MUELLER",
"first_name": "KELLY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-12",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "268837",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WI",
"license": "22300-875",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100199202",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2414 Kohler Memorial Dr",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530813129",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kdonnellymueller340391@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2414 Kohler Memorial Dr",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530813129",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.