| Aurora Psychiatric Hospital, Inc. | |
|
1220 Dewey Ave Wauwatosa WI 53213 | |
| (414) 454-6600 | |
| Not Available |
| Full Name | Aurora Psychiatric Hospital, Inc. |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 1220 Dewey Ave, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Nan Nelson (TREASURER) |
| Authorized Official Contact | 4142991610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aurora Psychiatric Hospital, Inc. 1220 Dewey Ave Wauwatosa WI 53213-2504 Ph: (414) 454-6600 | Aurora Psychiatric Hospital, Inc. 1220 Dewey Ave Wauwatosa WI 53213 Ph: (414) 454-6600 |
| NPI Number | 1881627438 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 09/12/2018 |
| Medicare PECOS PAC ID | 5799682076 |
|---|---|
| Medicare Enrollment ID | O20031215000930 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881627438 | NPI | - | NPPES |
| 43007900 | Medicaid | WI | |
| 100068881 | Medicaid | WI | |
| 10062800 | Medicaid | WI | |
| 42238300 | Medicaid | WI |
| Provider Name | Maritoni M Abraham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083649925 PECOS PAC ID: 4981598109 Enrollment ID: I20040210000277 |
| Provider Name | Herbert G Roehrich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811032378 PECOS PAC ID: 7810985215 Enrollment ID: I20040504001243 |
| Provider Name | John P Mullooly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649356254 PECOS PAC ID: 2860479029 Enrollment ID: I20040706000769 |
| Provider Name | Larry R Sprung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447278940 PECOS PAC ID: 5799742953 Enrollment ID: I20041220000471 |
| Provider Name | Michael G Deeken |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851337646 PECOS PAC ID: 1557310463 Enrollment ID: I20050623000991 |
| Provider Name | Yoganand Gundamraj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104859370 PECOS PAC ID: 5890716096 Enrollment ID: I20051215000617 |
| Provider Name | Jeffrey Bahr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770511453 PECOS PAC ID: 0042234866 Enrollment ID: I20060119000742 |
| Provider Name | Lori R Settersten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750424123 PECOS PAC ID: 7315956224 Enrollment ID: I20060420000133 |
| Provider Name | Venkatarama Rao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144338989 PECOS PAC ID: 5597846626 Enrollment ID: I20080115000558 |
| Provider Name | Ankur N Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043327372 PECOS PAC ID: 4688743412 Enrollment ID: I20080520000684 |
| Provider Name | Lisa M Blaeser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588782353 PECOS PAC ID: 0446318646 Enrollment ID: I20081016000225 |
| Provider Name | Robert L Loiben |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346302072 PECOS PAC ID: 9335335686 Enrollment ID: I20101129000296 |
| Provider Name | Julie A Offutt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225288509 PECOS PAC ID: 9830373083 Enrollment ID: I20110412000891 |
| Provider Name | Anthony D Meyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285848812 PECOS PAC ID: 3274426648 Enrollment ID: I20110511000489 |
| Provider Name | Dinshah D Gagrat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194740068 PECOS PAC ID: 4385679281 Enrollment ID: I20111110000180 |
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