NPIMap

Individual provider Active NPI

Jorge Gilberto Mascaro Carvajal, MD, FRCS

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Milwaukee, WI
National Provider Identifier
1932948635
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
13-876 Issued in WI
Practice address
9200 W Wisconsin Ave
Center for Advanced Care
Milwaukee, WI 53226-3522
Phone
(414) 955-6900
Fax
(414) 955-0079
NPI assigned
May 22, 2024
Last updated
May 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 13-876 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Center for Advanced Care
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Avenue
Milwaukee, WI 53226-3222
Phone (414) 955-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240610000289 WI Practitioner - Cardiac SurgeryPractitioner - General Surgery 9739621467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: General Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13-876WIMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Oct 22, 2025 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Oct 22, 2025 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince May 22, 2024 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 805-8700

Interoperability endpoints

  • Direct secure messaging: jmascarocarvajal823902@direct.froedtert.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1932948635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVENUE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263222",
            "telephone_number": "414-955-6900",
            "fax_number": "414-955-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "CENTER FOR ADVANCED CARE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-955-6900",
            "fax_number": "414-955-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCARO CARVAJAL",
        "first_name": "JORGE",
        "middle_name": "GILBERTO",
        "name_prefix": "Dr.",
        "credential": "MD, FRCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WI",
            "license": "13-876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.