KENNETH T BASTIN (NPI# 1457393431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457393431 |
| Entity Type | Individual |
| Full Name | KENNETH T BASTIN |
| Credential | MD |
| Practice Address |
2900 W Oklahoma Ave Milwaukee WI 53215-4330 |
| Mailing Address |
11516 N Port Washington Rd Ste 202 Mequon WI 53092-3441 |
| Practice Telephone | 4146496420 |
| Practice Fax Number | 4146495309 |
| Mailing Telephone | 2622415040 |
| Mailing Fax Number | 2622415261 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2010-03-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
30541 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31641500 | 05 |
| Street Address |
2900 W OKLAHOMA AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53215-4330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386640811 | Moises A Garcia | Internal Medicine | 2900 W Oklahoma Ave, 5th Fl, Milwaukee, WI 53215-4330 | 2005-06-21 |
| 1366040883 | Amy Lynn Mann | Occupational Therapist | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-10-16 |
| 1992302616 | Taylor A Umpierrez | Nurse Practitioner | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-10-06 |
| 1831705664 | Fauzan Ali | Anesthesiologist Assistant | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-09-17 |
| 1992318091 | Sarah E Gelhaar | Nurse Practitioner | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-08-28 |
| 1831700483 | David J Guerard | Nurse Practitioner | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-08-16 |
| 1083225767 | Melanie M Quella | Nurse Practitioner | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-08-14 |
| 1740890219 | Kathleen Rose Silveira | Pharmacist | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-08-08 |
| 1245849264 | Anna K Coppin | Nurse Practitioner | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-07-27 |
| 1780209320 | Angie Knutson | Pharmacist | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-06-09 |
| Find all providers in the same location | ||||
| 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 | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| 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 Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861924482 | Katie Johannah Livingston | Radiology | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2017-04-02 |
| 1891157871 | Jacob Samuel Witt | Radiology | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2016-03-28 |
| 1679935860 | Amber Ann Retzlaff | Radiology | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2016-03-25 |
| 1912384280 | Saryleine Ortiz De Choudens | Radiology | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2015-05-06 |
| 1396131439 | Nina A Desai | Radiology | 8701 W Watertown Plank Rd, Milwaukee, WI 53226 | 2015-04-14 |
| 1124413422 | Daniel Paul Lindsay | Radiology | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2015-04-02 |
| 1205279957 | Musaddiq Javvad Awan | Radiology | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2013-04-12 |
| 1699038588 | Lindsay L Puckett | Radiology | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2012-06-17 |
| 1265708606 | Hina Saeed | Radiology | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2012-03-29 |
| 1801188230 | Jeffrey Alan Kittel | Radiology | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2011-05-03 |
| 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.