Individual provider Active NPI

Brooke Michelle Moungey, M.D.

  • Emergency Medicine Physician
  • Middleton, WI
National Provider Identifier
1942620752
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35134085 Issued in OH
Practice address
8540 Greenway Blvd
Middleton, WI 53562
Phone
(608) 219-4016
NPI assigned
Apr 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35134085 OH Primary
Emergency Medicine Physician 207P00000X 6576120 WI

Addresses

Primary practice location

8540 Greenway Blvd
Middleton, WI 53562

Mailing address

700 Ackerman Rd
Ste 570
Columbus, OH 43202-1579
Phone (614) 293-2594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180712003143 OH Practitioner - Emergency Medicine 9234353483 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Emergency Medicine LLCGroup PAC ID 2668386673, 169 clinicians
Osu Observation Medicine, LLCGroup PAC ID 3375692270, 423 clinicians

Practice addresses (Care Compare)

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8305

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35134085OHMDEmergency Medicine Physician
6576120WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Emergency Professionals Inc Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
Osu Emergency Medicine LLC CurrentSince Jul 1, 2018 Accepting new patients
Osu Observation Medicine, LLC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1942620752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD",
            "address_2": "STE 570",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021579",
            "telephone_number": "614-293-2594",
            "fax_number": "614-293-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 GREENWAY BLVD",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "53562",
            "telephone_number": "608-219-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNGEY",
        "first_name": "BROOKE",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35134085",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "6576120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

Verify at the official NPI Registry.