MICHAEL BALISTRERI (NPI# 1225353055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225353055 |
| Entity Type | Individual |
| Full Name | MICHAEL BALISTRERI |
| Credential | M.D. |
| Practice Address |
700 S Park St Madison WI 53715-1830 |
| Practice Telephone | 6082516100 |
| Practice Fax Number | 6082586772 |
| Mailing Telephone | 6082516100 |
| Mailing Fax Number | 6082586772 |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
56561-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1225353055 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 700 S Park St, Madison, WI 537151830 | 6082516100 |
| Street Address |
700 S PARK ST |
| City | MADISON |
| State | WI |
| Zip Code | 53715-1830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134123003 | Marilyn J Borst | Surgery | 700 S Park St, Madison, WI 53715-1830 | 2005-06-09 |
| 1487266714 | Charlene Jenkins | Nurse Practitioner | 700 S Park St, Madison, WI 53715-1830 | 2020-08-18 |
| 1073130480 | Amanda Mcafee | Nurse Practitioner | 700 S Park St, Madison, WI 53715-1830 | 2020-07-01 |
| 1235759150 | Edriss Drammeh | Nurse Practitioner | 700 S Park St, Madison, WI 53715-1830 | 2020-04-21 |
| 1700424777 | Elizabeth H Kuhn | Nurse Anesthetist, Certified Registered | 700 S Park St, Madison, WI 53715-1830 | 2019-12-20 |
| 1295373710 | Lauren Nicole Tobasco | Physician Assistant | 700 S Park St, Madison, WI 53715-1830 | 2019-12-16 |
| 1629610795 | Amanda L Schneider | Nurse Anesthetist, Certified Registered | 700 S Park St, Madison, WI 53715-1830 | 2019-10-10 |
| 1366092017 | Mitchell John Wilkins | Nurse Anesthetist, Certified Registered | 700 S Park St, Madison, WI 53715-1830 | 2019-09-16 |
| 1578119285 | Gary Terlizzi | Nurse Anesthetist, Certified Registered | 700 S Park St, Madison, WI 53715-1830 | 2019-08-18 |
| 1699327304 | Ann R Madden | Nurse Anesthetist, Certified Registered | 700 S Park St, Madison, WI 53715-1830 | 2019-07-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1578927026 | Petra A Kelsey | Family Medicine | 1107 Emerald St, Madison, WI 53715 | 2016-04-11 |
| 1467889238 | Group Health Cooperative of South Central Wi | Durable Medical Equipment & Medical Supplies | 740 Regent Street, Suite 106, Madison, WI 53715 | 2013-10-10 |
| 1275888760 | Sandra Beth Miller | Physician Assistant | 700 S. Park, Suite A 404, Madison, WI 53715 | 2012-07-20 |
| 1134418486 | Matthew Lochen | Emergency Medicine | 700 S. Park Street, Department of Emergency Medicine, Madison, WI 53715 | 2011-04-06 |
| 1225275720 | Eileen J Breitweiser | Social Worker | 202 South Parkt Street, Madison, WI 53715 | 2009-01-21 |
| 1225293137 | Kenneth H. Yuska, Md, Sc | Orthopaedic Surgery | 4726 East Towne Blvd., 110, Madison, WI 53715 | 2008-07-21 |
| 1063689727 | Rachel I Kornik | Dermatology | Uw Health Dept of Dermatology 1 S. Park St, Administrative Office 7th Floor, Madison, WI 53715 | 2008-05-13 |
| 1144434911 | Rebecca Sue Frye | Pharmacist | 1 South Park Street, Suite 101 Pharmacy, Madison, WI 53715 | 2007-05-10 |
| 1376755496 | Eileen C. Scrivner | Social Worker | 1008 Fish Hatchery Road, Madison, WI 53715 | 2007-05-03 |
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| Taxonomy Code | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336431139 | Geoffrey Howard Gordon | Obstetrics & Gynecology | 737 Apollo Way, Madison, WI 53718-2913 | 2011-05-11 |
| 1548218886 | Chanel T Tyler | Obstetrics & Gynecology | 7021 Colony Dr, Madison, WI 53717-1407 | 2006-05-05 |
| 1811966211 | Dinesh M Shah | Obstetrics & Gynecology | 117 S Hamilton St Apt 807, Madison, WI 53703-4415 | 2006-03-16 |
| 1811330376 | Jacquelyn Hanna Adams | Obstetrics & Gynecology | 202 S Park St, Madison, WI 53715-1507 | 2013-04-15 |
| 1912297102 | Kathleen Antony | Obstetrics & Gynecology | 202 S Park St, Madison, WI 53715-1507 | 2011-04-09 |
| 1063677920 | Kara Kjersten Hoppe | Obstetrics & Gynecology | 202 S Park St, Madison, WI 53715-1507 | 2008-07-21 |
| 1285757997 | Jesus Igor Iruretagoyena | Obstetrics & Gynecology | 202 S Park St, Madison, WI 53715-1507 | 2007-04-09 |
| 1164589529 | Brian Robert Stafeil | Obstetrics & Gynecology | 700 S Park St, Madison, WI 53715-1830 | 2007-01-03 |
| 1841232873 | Susan R Davidson | Obstetrics & Gynecology | 700 S Park St, St Marys Hospital/dean Medical Center, Madison, WI 53715-1849 | 2006-06-12 |
| 1477502656 | Jennifer L Krupp | Obstetrics & Gynecology | 700 S Park St, Madison, WI 53715-1830 | 2006-05-08 |
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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.