NPIMap

Individual provider Active NPI

Milagros R Cuaresma-Ambas, M.D.

  • Psychiatry Physician
  • Appleton, WI
National Provider Identifier
1962562710
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
32433 Issued in WI
Practice address
320 S. Walnut St.
Appleton, WI 54911-5918
Phone
(920) 832-4741
Fax
(920) 832-2185
NPI assigned
Dec 11, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 32433 WI Primary
Psychiatry Physician 2084P0800X 32433 WY

Addresses

Primary practice location

320 S. Walnut St.
Appleton, WI 54911-5918

Mailing address

320 S. Walnut St.
Appleton, WI 54911-5918
Phone (920) 832-4741

Other identifiers 1

IdentifierTypeStateIssuer
31938500MedicaidWI

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
I20050718000346 WI Practitioner - Psychiatry 7517993900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of OutagamieGroup PAC ID 7517930019, 9 clinicians

Practice addresses (Care Compare)

320 S Walnut St
Appleton, WI 54911-5918
Phone (920) 832-1624

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32433WIMDPsychiatry Physician
32433WYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Outagamie CurrentSince Jun 24, 2002 Accepting new patients
Winnebago Mental Health Institute Past Accepting new patients

Locations

320 S Walnut St
Appleton, WI 54911
Phone (920) 832-1624

401 S Elm St
Appleton, WI 54911
Phone (414) 832-5270

410 S Walnut St
Appleton, WI 54911
Phone (920) 832-4741

Interoperability endpoints

  • Direct secure messaging: milagros.cuaresma-ambas.1@18748.direct.athenahealth.com

Organizations & group practices 2

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962562710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S. WALNUT ST.",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-4741",
            "fax_number": "920-832-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S. WALNUT ST.",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-4741",
            "fax_number": "920-832-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUARESMA-AMBAS",
        "first_name": "MILAGROS",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "32433",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WY",
            "license": "32433",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31938500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.