Individual provider Active NPI

Alvie Wafiq Ahsan, MD

  • Pediatrics Physician
  • Greenfield, WI
National Provider Identifier
1962909440
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
85028 Issued in WI
Practice address
9000 W Sura LN
Greenfield, WI 53228-3477
Phone
(414) 246-6800
NPI assigned
Apr 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 308900-01 NY
Pediatrics Physician 208000000X 85028 WI Primary

Addresses

Primary practice location

9000 W Sura LN
Greenfield, WI 53228-3477

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

158-49 84th St
Howard Beach, NY 11414-3020
Phone (718) 322-3463

Other identifiers 1

IdentifierTypeStateIssuer
100305478MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address aahsan419407@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210914002924 NY Practitioner - Pediatric Medicine 3476959578 Reassigns benefits to 1 organization
I20250122002735 WI Practitioner - Pediatric Medicine 3476959578 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308900-01NYMDPediatrics Physician
85028WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince Sep 6, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Sep 6, 2021 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

15849 84th St
Howard Beach, NY 11414
Phone (718) 322-3463

972 Brush Hollow Rd
Westbury, NY 11590

9000 W Sura Ln
Milwaukee, WI 53228
Phone (414) 246-6500

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1962909440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W SURA LN",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283477",
            "telephone_number": "414-246-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "158-49 84th St",
            "address_purpose": "LOCATION",
            "city": "Howard Beach",
            "state": "NY",
            "postal_code": "114143020",
            "country_code": "US",
            "telephone_number": "718-322-3463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHSAN",
        "first_name": "ALVIE",
        "middle_name": "WAFIQ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "308900-01",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "85028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100305478",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9000 W Sura Ln",
            "city": "Greenfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532283477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aahsan419407@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9000 W Sura Ln",
            "city": "Greenfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532283477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.