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PROHEALTH MEDICAL GROUP INC
NPI 1023753688
Clinic/Center - Radiology in Waukesha, WI

Active since April 28, 2022CLIA Certified · 6 labs
1111 DELAFIELD ST, WAUKESHA, WI 53188(262) 928-4300 Get Directions Write a Review

NPPES record last updated: May 23, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 23, 2022, Apr 29, 2022 (2 updates tracked since 2022).

About Prohealth Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROHEALTH MEDICAL GROUP INC (NPI 1023753688) is a healthcare organization registered as a radiology in Waukesha, Wisconsin and active in the NPI registry since April 2022. The organization holds 6 active CLIA laboratory certificates and lists Thomas W Johnson, Reimbursement Manager, as its authorized official.

NPPES Registry Identity

NPI1023753688
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NamePROHEALTH MEDICAL GROUP INC
Location Address1111 DELAFIELD STWaukesha, WI 53188-3417
Mailing AddressN17w24100 Riverwood Dr Ste 250Waukesha, WI 53188-1177
Phone(262) 928-4300
Organization SubpartYes
Authorized OfficialThomas W JohnsonReimbursement Manager · (262) 928-4704
Enumeration DateApril 28, 2022
Last NPPES UpdateMay 23, 20222 updates tracked since enumeration
NPPES CertifiedMay 23, 2022
✔ NPI 1023753688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
1111 DELAFIELD ST, Waukesha, WI 53188
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CLIA Laboratory Certificates CMS CLIA 7

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2167280

Prohealth Medical Group, Inc - Waukesha Delafield Street · Waukesha, WI
Active · expires Jun 4, 2027
CLIA Number52D2167280
Laboratory TypeCommunity Clinic
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorDr. Mark Grossklaus
Laboratory Phone(262) 542-9212
Laboratory LocationProhealth Medical Group, Inc - Waukesha Delafield Street1111 Delafield St Suite 112, Waukesha, WI 53188
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 52D0665546

Prohealth Medical Group, Inc - Waukesha Barstow Street · Waukesha, WI
Active · expires Apr 11, 2028
CLIA Number52D0665546
Laboratory TypePhysician Office
Certificate Effective DateApril 12, 2026
Certificate Expiration DateApril 11, 2028
Laboratory DirectorDr. Jennifer L. Zeman
Laboratory Phone(262) 513-7334
Laboratory LocationProhealth Medical Group, Inc - Waukesha Barstow Street210 NW Barstow St Suite 201, Waukesha, WI 53188
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 52D0857441

Prohealth Medical Group, Inc - Waukesha Moreland Boulevard · Waukesha, WI
Active · expires Mar 2, 2028
CLIA Number52D0857441
Laboratory TypePhysician Office
Certificate Effective DateMarch 3, 2026
Certificate Expiration DateMarch 2, 2028
Laboratory DirectorDr. Mark D. Grossklaus
Laboratory Phone(262) 542-9100
Laboratory LocationProhealth Medical Group, Inc - Waukesha Moreland Boulevard717 W Moreland Blvd, Waukesha, WI 53188
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 52D1010578

Prohealth Medical Group, Inc - Heart And Vascular Services · Waukesha, WI
Active · expires Feb 9, 2028
CLIA Number52D1010578
Laboratory TypeCommunity Clinic
Certificate Effective DateFebruary 10, 2026
Certificate Expiration DateFebruary 9, 2028
Laboratory DirectorDr. Matthew Weinberg
Laboratory Phone(262) 549-1516
Laboratory LocationProhealth Medical Group, Inc - Heart And Vascular ServicesProhealth Heart & Vascular Care 725 American Avenue, Waukesha, WI 53188
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 52D2152243

Prohealth Medical Group, Inc - Pewaukee Specialty Dermatology · Waukesha, WI
Active · expires Sep 12, 2027
CLIA Number52D2152243
Laboratory TypePhysician Office
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorDr. Christopher T. Burnett
Laboratory Phone(262) 696-5571
Laboratory LocationProhealth Medical Group, Inc - Pewaukee Specialty DermatologyN16w24131 Riverwood Dr Pewaukee Specialty 2nd Floor, Waukesha, WI 53188
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 52D2093177

Prohealth Medical Group, Inc - Behavioral Health Services · Waukesha, WI
Active · expires Mar 22, 2027
CLIA Number52D2093177
Laboratory TypeCommunity Clinic
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorDr. Michael Raster
Laboratory Phone(262) 928-7668
Laboratory LocationProhealth Medical Group, Inc - Behavioral Health Services721 American Ave, Suite 501, Waukesha, WI 53188
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREGORY R LOCHEN M.D.
Ophthalmology
1111 DELAFIELD ST, SUITE 312
WAUKESHA, WI 53188
Waukesha County (262) 547-3352
MRS. ALYSSA KATHRYN EISNER PA
Physician Assistant
1111 DELAFIELD ST, SUITE 209
WAUKESHA, WI 53188
Waukesha County (262) 542-0444
CHRISTINA K HILL LAT
Specialist/Technologist (Athletic Trainer)
1111 DELAFIELD ST, STE 120
WAUKESHA, WI 53188
Waukesha County (262) 521-9762
DR. FRANCESCA JEAN MARTIN D.D.S.
Dentist (General Practice)
1111 DELAFIELD ST, #319
WAUKESHA, WI 53188
Waukesha County (262) 549-3641
MRS. DEBRA SEILER NP
Nurse Practitioner (Family)
1111 DELAFIELD ST, SUITE 215
WAUKESHA, WI 53188
Waukesha County (262) 542-2594
VASAVI KUMAR PA
Physician Assistant
1111 DELAFIELD ST, STE 209
WAUKESHA, WI 53188
Waukesha County (262) 542-0444
MS. ERIN E DOXTATOR PT
Physical Therapist
1111 DELAFIELD ST, SUITE 120
WAUKESHA, WI 53188
Waukesha County (262) 521-9762
DEBRA J. OLSON M.D.
Obstetrics & Gynecology
1111 DELAFIELD ST, SE 311
WAUKESHA, WI 53188
Waukesha County (262) 544-4411

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prohealth Medical Group Inc's NPI number?

The NPI number for Prohealth Medical Group Inc is 1023753688. It was assigned to this organization in the NPPES registry on April 28, 2022.

Where is Prohealth Medical Group Inc located?

Prohealth Medical Group Inc is located at 1111 Delafield St, Waukesha, WI 53188. The listed phone number is (262) 928-4300.

What is Prohealth Medical Group Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.

Does Prohealth Medical Group Inc hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Prohealth Medical Group Inc was last updated on May 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.