CMS-1500 Box 24J / 33a • NPI
1013959766
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207R00000X (CMS 11)
Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)
Box 32 Service Location & ZIP+4
3113 S 13TH ST, MILWAUKEE, WI, 53215-4609
✓ 9-Digit EDI 837 ZIP+4 (53215-4609)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1013959766 (ADVANCED HEALTH AND WELLNESS MEDICAL CENTER, SC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1013959766 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVANCED HEALTH AND WELLNESS MEDICAL CENTER, SC |
| Plain-English Specialty | Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: 207R00000X (Internal Medicine) |
| Certifying / Licensing Body | American Board of Internal Medicine (ABIM) |
| Practice Location Address | 3113 S 13TH ST, MILWAUKEE, WI, 53215-4609 |
| Practice Telephone / Fax | Tel: (414) 643-6000 | Fax: (414) 643-1352 |
| Administrative Mailing Address | PO BOX 670, BROOKFIELD, WI, 53008-0670 |
| Enumeration & Last Sync | Enumerated: 2006-06-10 | CMS Record Updated: 2025-09-11 |
| Authorized Official | RAYMOND JANUSZ (President) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207R00000X)
What Does Taxonomy Code 207R00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207R00000X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVANCED HEALTH AND WELLNESS MEDICAL CENTER, SC)
Typical CPT / Diagnostic Procedures:- Complex Multi-System Adult Diagnostic Workup (CPT 99204–99215)
- Preoperative Medical Risk Assessment & Cardiac Clearance
- Chronic Kidney, Hepatic & Metabolic Panel Interpretation
- Adult Inpatient Hospitalist Management & Discharge Coordination
- Antihypertensives (ACE Inhibitors, ARBs, Calcium Channel Blockers, Thiazides)
- Oral Antidiabetic Agents, Basal/Bolus Insulins & Lipid-Lowering Statins
- Direct Oral Anticoagulants (Apixaban, Rivaroxaban) & Antiplatelets
- Levothyroxine (Hypothyroidism) & Proton Pump Inhibitors (Pantoprazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
225100000X — Physical TherapistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist | State: WI | License: 642024 | Primary: Secondary |
225700000X — Massage TherapistPlain English: Licensed & Credentialed Massage Therapist | State: WI | License: 1238046 | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: WI | License: 37239 | Primary: Yes (Primary) |
111N00000X — ChiropractorPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor | State: WI | License: 2411012 | Primary: Secondary |
111N00000X — ChiropractorPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor | State: WI | License: 3936012 | Primary: Secondary |
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: WI | License: 27806021 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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