1. Home
  2. Directory
  3. Wisconsin
  4. Milwaukee
  5. General Practice
  6. NPI Profile

DR. DOUGLAS GROVE MD
NPI 1154941102
General Practice in Milwaukee, WI

Active since April 20, 2020PECOS Enrolled
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226(414) 805-2715 Get Directions Write a Review

NPPES record last updated: December 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 14, 2022, Apr 20, 2020 (2 updates tracked since 2020).

About Dr. Douglas Grove Md NPPES

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

DR. DOUGLAS GROVE MD (NPI 1154941102) is an individual general practice provider in Milwaukee, Wisconsin, licensed in Missouri (2022041020) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154941102
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. DOUGLAS GROVECredential: MD
Location Address9200 W WISCONSIN AVEMilwaukee, WI 53226-3522
Mailing Address9200 W Wisconsin AveMilwaukee, WI 53226-3522 · (414) 805-2715
Phone(414) 805-2715
Sole ProprietorNo
Enumeration DateApril 20, 2020
Last NPPES UpdateDecember 14, 20222 updates tracked since enumeration
NPPES CertifiedNovember 30, 2022
✔ NPI 1154941102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MO · 2022041020
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
9200 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Douglas Grove Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

TRACY BLAIR WANDTKE HERRMANN APNP, CNM
Advanced Practice Midwife
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-4777
DR. ZACHARY SMITH DO
Internal Medicine (Gastroenterology)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-6830
DR. COLLEEN ANN CROWE M.D., M.P.H.
Emergency Medicine
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6469
ROBERTO MEJIAS APNP
Nurse Practitioner (Pediatrics)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6600
MRS. ANNE E B LAKATOS APN-BC, APNP, RN
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
MRS. AMANDA M MANDERS APNP
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
KATHLEEN A WATERHOUSE-SKIBICKI CRNA
Nurse Anesthetist, Certified Registered
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-5951
ANDREA L BEQUEST PA
Physician Assistant (Medical)
9200 W WISCONSIN AVE, INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-0350

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 Douglas Grove's NPI number?

The NPI number for Douglas Grove is 1154941102. It was assigned to this individual provider in the NPPES registry on April 20, 2020.

Where is Douglas Grove located?

Douglas Grove practices at 9200 W Wisconsin Ave, Milwaukee, WI 53226. The listed phone number is (414) 805-2715.

What is Douglas Grove's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Douglas Grove enrolled in Medicare?

Yes. Douglas Grove is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Douglas Grove was last updated on December 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.