John L Waeltz (NPI# 1174638621, PAC ID# 0244275071) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1174638621 |
| PAC ID by PECOS | 0244275071 |
| Professional Enrollment ID | I20050622001125 |
| Full Name | John L Waeltz |
| Organization Legal Name | ASCENSION MEDICAL GROUP SOUTHEAST WISCONSIN INC |
| Address |
4655 N Port Washington Rd Suite 100 Glendale WI 53212-1070 |
| Phone Number | 4142597575 |
| Gender | M |
| Credential | MD |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1980 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 8628980943 |
| Number of Group Practice Members | 586 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520136 | WHEATON FRANCISCAN ST JOSEPH |
| Address | Phone | Organization |
|---|---|---|
| 4655 N Port Washington Rd, Suite 100, Glendale, WI 53212-1070 | 4142597575 | ASCENSION MEDICAL GROUP SOUTHEAST WISCONSIN INC |
| Organization Legal Name | ASCENSION MEDICAL GROUP SOUTHEAST WISCONSIN INC |
| Physicians | 462 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Neal James Campbell Ii | Family Medicine | Ascension Medical Group Southeast Wisconsin Inc | 3610 Michelle Witmer Memorial Dr, New Berlin, WI 53151-5292 |
| David James Coulter | Cardiovascular Disease (cardiology) | Ascension Medical Group Southeast Wisconsin Inc | 2025 W Oklahoma Ave, Suite 105, Milwaukee, WI 53215-4455 |
| Danielle L Laczniak | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 3070 N 51st St, Suite 601, Milwaukee, WI 53210-1663 |
| Lisa Marie Leblanc | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 3040 N 117th St, Suite 200, Wauwatosa, WI 53222-4129 |
| Jorja K Mueller | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 7400 W Rawson Ave, Suite G40, Franklin, WI 53132-8114 |
| Breana C Cummens | Family Medicine | Ascension Medical Group Southeast Wisconsin Inc | 4600 W Loomis Rd, Greenfield, WI 53220-4858 |
| Katie L Leiteritz | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 8020 S Howell Ave, Oak Creek, WI 53154-2930 |
| Brian Zafonte | Hand Surgery | Ascension Medical Group Southeast Wisconsin Inc | 3811 Spring St, Suite 102, Mount Pleasant, WI 53405-1667 |
| Irina Ciubotaru | Endocrinology | Ascension Medical Group Southeast Wisconsin Inc | 3805 Spring St, Suite 310, Mount Pleasant, WI 53405-1600 |
| Carlos R Galvao Sobrinho | Nephrology | Ascension Medical Group Southeast Wisconsin Inc | 3805 B Spring St, Suite 260, Mount Pleasant, WI 53405-1643 |
| Street Address |
4655 N PORT WASHINGTON RD SUITE 100 |
| City | GLENDALE |
| State | WI |
| Zip | 53212-1070 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael H Gilman | Obstetrics/gynecology | Ascension Medical Group Southeast Wisconsin Inc | 4655 N Port Washington Rd, Suite 125, Glendale, WI 53212-1004 |
| Linda Marie Wesp | Nurse Practitioner | 4655 N Port Washington Rd, Suite 325, Glendale, WI 53212-1000 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Curtis A Crimmins | Hand Surgery | Hand To Shoulder Specialists of Wisconsin Ltd | 575 W River Woods Pkwy, Glendale, WI 53212-1003 |
| David W Meister | Orthopedic Surgery | Hand To Shoulder Specialists of Wisconsin Ltd | 575 W River Woods Pkwy, Glendale, WI 53212-1003 |
| Jacqueline S Mlsna | Orthopedic Surgery | Wisconsin Bone and Joint Sc | 525 W River Woods Pkwy, Suite 130, Glendale, WI 53212-1010 |
| Anthony A Ferguson | Orthopedic Surgery | Wisconsin Bone and Joint Sc | 525 W River Woods Pkwy, Suite 130, Glendale, WI 53212-1010 |
| Joseph A Locke | Pain Management | 4111 N Port Washington Rd, Milwaukee, WI 53212-1029 | |
| Syed Q Hussaini | Psychiatry | 4111 N Port Washington Rd, Milwaukee, WI 53212-1029 | |
| Dean W Ziegler | Orthopedic Surgery | Blount Orthopaedic Associates Sc | 525 W River Woods Pkwy, Suite 100, Glendale, WI 53212-1061 |
| John A Roffers | Physical Medicine and Rehabilitation | 525 W River Woods Pkwy, Suite 240, Glendale, WI 53212-1061 | |
| Zoe R Ziegler | Physician Assistant | Blount Orthopaedic Associates Sc | 525 W River Woods Pkwy, Suite 100, Glendale, WI 53212-1061 |
| Joelle K Ottoson | Clinical Social Worker | Affiliated Wellness Group LLC | 4650 N Port Washington Rd, Lexington Entrance Barnabas Center, Milwaukee, WI 53212-1077 |
| Find all physicians in zip 53212 | |||
| City | GLENDALE |
| Zip Code | 53212 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | GLENDALE + OBSTETRICS/GYNECOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.