NPIMap

Individual provider Active NPI

Safoora Mahmood Choudry

  • Vascular Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1982086948
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2020012675 Issued in MO
Practice address
2801 W Kinnickinnic River Pkwy Ste 380
Milwaukee, WI 53215-3632
Phone
(474) 649-3370
Fax
(414) 385-2461
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 2020012675 MO Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy Ste 380
Milwaukee, WI 53215-3632

Mailing address

2801 W Kinnickinnic River Pkwy Ste 380
Milwaukee, WI 53215-3632
Phone (474) 649-3370

Other practice location 1

3220 Bluff Creek Dr
Suite 100
Columbia, MO 65201-3525
Phone (573) 443-8773

Other identifiers 1

IdentifierTypeStateIssuer
100186603MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address schoudry326106@direct.myadvocateaurora.org Direct

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
I20211216002057 WI Practitioner - Vascular Surgery 1759694250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600

975 Port Washington Rd
Suite 320
Grafton, WI 53024-9201
Phone (262) 329-8100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)11
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jan 3, 2022 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jan 3, 2022 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 3, 2022 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 3, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

975 Port Washington Rd
#320
Grafton, WI 53024
Phone (262) 329-8100

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

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

2801 W Kinnickinnic River Pkwy
Ste 380
Milwaukee, WI 53215
Phone (474) 649-3370

Organizations & group practices 5

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 9

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1982086948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 380",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153632",
            "telephone_number": "474-649-3370",
            "fax_number": "414-385-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 380",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153632",
            "telephone_number": "474-649-3370",
            "fax_number": "414-385-2461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3220 Bluff Creek Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652013525",
            "country_code": "US",
            "telephone_number": "573-443-8773",
            "fax_number": "573-443-6843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOUDRY",
        "first_name": "SAFOORA",
        "middle_name": "MAHMOOD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "2020012675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100186603",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 380",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schoudry326106@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 380",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.