Ellen Hallberg

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

76267 Issued in WI

Practice address

1121 E North Ave
Milwaukee, WI 53212-3515

Phone

(414) 267-6502

Fax

(414) 267-3892

NPI assigned

Mar 27, 2020

Last updated

May 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Family Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
• Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

Merit-based Incentive Payment System (MIPS)

Final score

87.99 of 100Reported as group

Quality

82.81

Promoting interoperability

100

Improvement activities

40

Cost

77.15

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• Milwaukee Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1518005818
  Medicare reassignment NPD
• Outreach Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1710032669
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Family Medicine

  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• Milwaukee Health Services Inc

  dba Martin Luther King Heritage Health Center

  • Case Management Agency
  • Milwaukee, WI
  • NPI 1346657442
  NPD
• Outreach Community Health Centers, Inc.

  dba Outreach Community Health Ctr at Wellpoint Care Ntwk

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1558231563
  NPD
• Prohealth Medical Group Inc

  • Internal Medicine Physician
  • Watertown, WI
  • NPI 1629119417

  Family Medicine

  NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prohealth Oconomowoc Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Oconomowoc, WI
  • NPI 1366420531
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  dba ProHealth Pharmacy - Oconomowoc

  • Community/Retail Pharmacy
  • Oconomowoc, WI
  • NPI 1497942205

  Hospital

  Care Compare affiliation
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1942838941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E NORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123515",
            "telephone_number": "414-267-6502",
            "fax_number": "414-267-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E NORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123515",
            "telephone_number": "414-267-6502",
            "fax_number": "414-267-3892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 N Dr Martin Luther King Jr Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532122709",
            "country_code": "US",
            "telephone_number": "414-372-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALLBERG",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "76267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942838941",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Adrian Hall, MD
• Hall's Brace Cent
• Emily R Halla, AUD, CCC-A
• Mike John Hallam, PHARMD
• Madison Eva Hallanger, PT, DPT
• Taylor Hallcox, MD
• Suzanne Bowes Halling, LCSW
• Robert J Hallock, M.D.
• Eric W Halpern, MD
• Amanda Halpin, D.O.

• Family Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.

Verify at the official NPI Registry.