BRADLEY THEODORE JOHN STRAKA (NPI# 1326031964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326031964 |
| Entity Type | Individual |
| Full Name | BRADLEY THEODORE JOHN STRAKA |
| Credential | MD |
| Practice Address |
2607 N Grandview Blvd Ste 125 Waukesha WI 53188-1686 |
| Practice Telephone | 4144550919 |
| Practice Fax Number | 4144550905 |
| Mailing Telephone | 2622904540 |
| Mailing Fax Number | 2622292220 |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2017-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 44600020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34279600 | 05 | |
| WI | RAILROAD MEDICARE | 070017188 | 01 |
| WI | RAILROAD MEDICARE | 070017187 | 01 |
| Street Address |
2607 N GRANDVIEW BLVD STE 125 |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-1686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508409806 | Kendra Bittner | Counselor | 2607 N Grandview Blvd, Waukesha, WI 53188-1686 | 2019-10-21 |
| 1790216554 | Highlander Dermatology LLC | Clinic/Center | 2607 N Grandview Blvd, Ste 125, Waukesha, WI 53188-1686 | 2017-03-23 |
| 1134650302 | Michael Richard Gissibl | Counselor | 2607 N Grandview Blvd, Suite 110, Waukesha, WI 53188-1686 | 2017-03-21 |
| 1174975411 | Midwest Natural Healing | Chiropractor | 2607 N Grandview Blvd, Waukesha, WI 53188-1686 | 2016-07-11 |
| 1245680081 | Debra Sarnowski | Counselor | 2607 N Grandview Blvd, Suite 110, Waukesha, WI 53188-1686 | 2016-06-13 |
| 1750741013 | Nicole Flannery | Counselor | 2607 N Grandview Blvd, #110, Waukesha, WI 53188-1686 | 2016-03-01 |
| 1902208283 | Amy Hoffman | Nurse Practitioner | 2607 N Grandview Blvd, Suite 150, Waukesha, WI 53188-1686 | 2014-09-18 |
| 1386051472 | Jessica Niedermayer | Counselor | 2607 N Grandview Blvd, Suite 108, Waukesha, WI 53188-1686 | 2014-07-21 |
| 1043633159 | Gary Swan | Counselor | 2607 N Grandview Blvd, Suite 104, Waukesha, WI 53188-1686 | 2014-01-24 |
| 1376970657 | Hope for A Better Tomorrow | Psychologist | 2607 N Grandview Blvd, Suite 110, Waukesha, WI 53188-1686 | 2013-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
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| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033478763 | Lauren Piilani Rimoin | Dermatology | W231n1440 Corporate Ct Ste 203, Waukesha, WI 53186-1303 | 2012-05-15 |
| 1083052690 | Brian W Lee | Dermatology | N16w24131 Riverwood Dr, Waukesha, WI 53188-1106 | 2013-06-06 |
| 1780863779 | Christopher Thomas Burnett | Dermatology | N16w24131 Riverwood Dr, Pewaukee Clinic, Waukesha, WI 53188-1106 | 2007-10-26 |
| 1346355443 | Marie Dauenhauer | Dermatology | W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | 2006-08-20 |
| 1700829959 | Affiliated Dermatologists Sc | Dermatology | 1111 Delafield Street, Ste 327, Waukesha, WI 53188 | 2006-06-14 |
| 1770558876 | J Christopher Braker | Dermatology | 2717 N Grandview Blvd, Waukesha, WI 53188 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174016596 | Dermatology and Cosmetic Physicians, Sc | Dermatology | W5192 Rienzi Rd, Fond Du Lac, WI 54935-9603 | 2018-06-11 |
| 1194248013 | Kyle Erick Rudningen | Dermatology | Uw Hosptials & Clinics 600 Highland Ave, Madison, WI 53792 | 2017-07-23 |
| 1194255521 | Rhonda Ganansky | Dermatology | W1383 N Bloomfield Rd, Lake Geneva, WI 53147-4429 | 2017-06-18 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1982066239 | Margaret Coleman Maxi | Dermatology | 188 Rockwood Ln Ste A, Neenah, WI 54956-1983 | 2016-03-25 |
| 1447612312 | Andrew C Duncanson | Dermatology | 510 N 17th Ave Ste C, Wausau, WI 54401-4281 | 2016-03-22 |
| 1225411481 | Gabriela A Maloney | Dermatology | 17100 W North Ave Ste 200, Brookfield, WI 53005-4489 | 2015-07-07 |
| 1043604424 | Marthe Ngongang Dika | Dermatology | 10500 W Loomis Rd Ste 110, Franklin, WI 53132-8030 | 2015-03-24 |
| 1902205206 | Affiliated Dermatologists | Dermatology | N96w17035 Division Rd, Suite A, Germantown, WI 53022-6419 | 2014-08-22 |
| 1568882793 | Kassandra E Holzem | Dermatology | 195 Discovery Dr, Brookfield, WI 53045 | 2014-04-28 |
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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.