MARY ALICE MUTH (APNP) – Nurse Practitioner, NPI 1669577482

MARY ALICE MUTH (APNP) is a healthcare provider. based in New berlin, Wisconsin. specializing in NURSE PRACTITIONER. They hold the professional credentials APNP. They hold a License No. 2862-033 (WI). The NPI Number for MARY ALICE MUTH (APNP) is 1669577482

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
MARY ALICE MUTH (APNP)
NPI
1669577482
Phone
(262) 789-1699
Address
13750 W NATIONAL AVE
Enumeration Date
14 September 2006
Last Update Date
7 January 2014

Doctor Profile

Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Secondary Phone
2629284704
Graduation Year
2005 (21 years ago)
PAC ID
3274538830
Group Practice PAC ID
3476465188
Professional Enrollment ID
I20061003000678
Address ID
WI531881127WAN17W2DRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

6,035 NURSE PRACTITIONER in WI

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Provider Addresses for MARY ALICE MUTH (APNP)

  • 13750, West National Avenue, New Berlin, Waukesha County, Wisconsin, 53151, United States

    PROHEALTH CARE MEDICAL ASSOCIATES INC.

    NEW BERLIN, WI 531514588

    Phone: (262) 789-1699

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-10-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20061003000678INurse PractitionerWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes137103$0
99213Established patient office or other outpatient visit, 20-29 minutes9783$0
99215Established patient office or other outpatient visit, 40-54 minutes1919$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit1515$0
View full utilization report →

Insurance plans in this area (ZIP 53151)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476465188View full group profile
NameSpecialtyState
-WI
-WI
Radiation OncologyWI
Clinical PsychologistWI
Cardiovascular Disease (Cardiology), Internal MedicineNY
Nurse PractitionerWI
-WI
Physician AssistantWI
Nurse PractitionerWI
Physician AssistantWI

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARY ALICE MUTH (APNP)?
MARY ALICE MUTH (APNP) — NPI 1669577482 — is the standard way to identify this listing.
Can I rely on MARY ALICE MUTH (APNP) being an active provider?
As of the registry snapshot, MARY ALICE MUTH (APNP) is marked active.
What is MARY ALICE MUTH (APNP)'s primary classification?
Nurse Practitioner is the headline specialty for MARY ALICE MUTH (APNP) here. Clinical services aligned with this taxonomy classification.
What address line appears for MARY ALICE MUTH (APNP)?
MARY ALICE MUTH (APNP)'s geographic hint is New Berlin, Wisconsin in our summary view.
Is the information about MARY ALICE MUTH (APNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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