DR. KITIMA BOONVISUDHI (NPI# 1134198005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134198005 |
| Entity Type | Individual |
| Full Name | DR. KITIMA BOONVISUDHI |
| Practice Address |
2901 W Kinnickinnic River Pkwy Ste 311 Milwaukee WI 53215-3677 |
| Practice Telephone | 4143858723 |
| Mailing Telephone | 4143858723 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2013-01-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 59966 | WI | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 204411 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02440095 | 05 |
| Street Address |
2901 W KINNICKINNIC RIVER PKWY STE 311 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53215-3677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536450 | John Pierrus Hanson Jr. | Internal Medicine | 2901 W Kinnickinnic River Pkwy, Ste 415, Milwaukee, WI 53215-3660 | 2005-05-23 |
| 1417588997 | Tara J Palma | Nurse Practitioner | 2901 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3677 | 2020-02-03 |
| 1215582440 | Jesslyn J Mcmahon | Nurse Practitioner | 2901 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3677 | 2019-08-05 |
| 1427531789 | Jessika Christine Kozik | Dental Hygienist | 2901 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3677 | 2018-09-12 |
| 1982143426 | Daniel R Wells | Nurse Practitioner | 2901 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3677 | 2017-02-16 |
| 1881132199 | Patrice Renee Fedel | Clinical Nurse Specialist | 2901 W Kinnickinnic River Pkwy, 403, Milwaukee, WI 53215-3677 | 2017-02-07 |
| 1144772161 | Cynthia Meier | Occupational Therapist | 2901 W Kinnickinnic River Pkwy, Suite 500, Milwaukee, WI 53215-3677 | 2016-10-25 |
| 1770032856 | Elise L Rozanski | Physician Assistant | 2901 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3677 | 2016-09-29 |
| 1699222521 | Julie Kindervater Maclellan | Occupational Therapist | 2901 W Kinnickinnic River Pkwy, Suite 500, Milwaukee, WI 53215-3677 | 2016-09-08 |
| 1568919066 | Amy E Barwick | Physical Therapist | 2901 W Kinnickinnic River Pkwy, Suite 500, Milwaukee, WI 53215-3677 | 2016-09-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841829918 | Joshua Michael Brooks | Student in an Organized Health Care Education/Training Program | Aurora St. Lukes Medical Center 2901 W Oklahoma Ave, Milwaukee, WI 53215 | 2020-04-02 |
| 1053967091 | Kristina Strupp | Clinical Nurse Specialist | 2900 W. Oaklahoma Avenue, Milwaukee, WI 53215 | 2019-08-15 |
| 1427510296 | Madelyn Pickle | Student in an Organized Health Care Education/Training Program | 2801 W. Kinnickinnic Rd Ste 250, Milwaukee, WI 53215 | 2019-04-02 |
| 1932601838 | Elizabeth D Morawski | Nurse Practitioner | 2801 Kinnickinnic Parkway, Suite 630, Milwaukee, WI 53215 | 2018-03-06 |
| 1457872673 | Canzata Kimberly Dent | Counselor | 2727 W. Cleveland Suite 204, Milwaukee, WI 53215 | 2017-06-28 |
| 1538689955 | Christian Pena | Durable Medical Equipment & Medical Supplies | 2800 W Forest Home Ave, Suite 100, Milwaukee, WI 53215 | 2017-06-27 |
| 1386178804 | Dane A Olsen | Family Medicine | 801 W Kinnickinnic River Pkwy., Suite 250, Milwaukee, WI 53215 | 2017-04-12 |
| 1811443492 | Thomas Diamond | Physical Therapist | 2901 Kinnickinnic Parkway, Milwaukee, WI 53215 | 2016-09-01 |
| 1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
| 1992105621 | Nicole R Hall | Nurse Practitioner | 2901 S Kinnickinnic Ave, Milwaukee, WI 53215 | 2014-08-29 |
| Find all providers in zip 53215 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1538570338 | Nicholas Sich | Surgery | 2901 W Kinnickinnic River Pkwy Dept Ste 540, Milwaukee, WI 53215-3677 | 2014-05-14 |
| 1629312467 | Meredith Witten | Surgery | 945 N 12th St # 2110, Milwaukee, WI 53233 | 2012-11-17 |
| 1013203397 | Nicole M Zaremba | Surgery | 2801 W Kinnickinnic River Pkwy Ste 165, Milwaukee, WI 53215-3699 | 2011-06-24 |
| 1073803391 | Ryan Berg | Surgery | 3070 N 51st St Ste 207, Milwaukee, WI 53210-1661 | 2011-04-08 |
| 1417119769 | Sheldon Morris Solochek | Surgery | 3316 N Lake Dr, Milwaukee, WI 53211-2907 | 2008-06-27 |
| 1194906982 | Muhammad Yousof Khan | Surgery | 1218 W Kilbourn Ave Ste 409, Milwaukee, WI 53233-1325 | 2007-11-20 |
| 1063611820 | Lyle G. Henry Md Sc | Surgery | 2015 E Newport Ave Ste 305, Milwaukee, WI 53211-2949 | 2007-07-12 |
| 1083789663 | Aaron L Rogaczewski | Surgery | 2111 N 60th St, Milwaukee, WI 53208-1043 | 2006-11-21 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.