Impact Physician Group, Wisconsin LLC
NPI 1174291025 · Internal Medicine Physician · Milwaukee, WI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Impact Physician Group, Wisconsin LLC is a Internal Medicine Physician organization in Milwaukee, WI (NPI 1174291025).
Provider details
- NPI number
- 1174291025
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Paul Miller, Ceo(678) 967-5599
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-09-03
- Last updated
- 2022-12-19
- Certified
- 2022-12-19
Frequently asked questions
- What is Impact Physician Group, Wisconsin LLC's NPI number?
- Impact Physician Group, Wisconsin LLC's National Provider Identifier (NPI) is 1174291025, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Impact Physician Group, Wisconsin LLC?
- Impact Physician Group, Wisconsin LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Impact Physician Group, Wisconsin LLC located?
- Impact Physician Group, Wisconsin LLC's practice location on file with NPPES is 3200 S 103rd St, Milwaukee, WI 53227-4104.
- What is Impact Physician Group, Wisconsin LLC's phone number?
- The practice phone number listed in the NPPES registry for Impact Physician Group, Wisconsin LLC is (469) 640-6500.
- Does Impact Physician Group, Wisconsin LLC accept Medicare?
- Impact Physician Group, Wisconsin LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Impact Physician Group, Wisconsin LLC?
- The authorized official listed on Impact Physician Group, Wisconsin LLC's NPPES record is Paul Miller, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Impact Physician Group, Wisconsin LLC's NPI active?
- Yes — Impact Physician Group, Wisconsin LLC's NPI (1174291025) is active in the NPPES registry as of the last update on 2022-12-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.