PAIN CENTERS OF WISCONSIN - WAUWATOSA, LLC (NPI# 1649663758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649663758 |
| Entity Type | Organization |
| Organization Name | PAIN CENTERS OF WISCONSIN - WAUWATOSA, LLC |
| Practice Address |
959 N Mayfair Rd Wauwatosa WI 53226-3465 |
| Mailing Address |
4131 W Loomis Rd Suite 300 Greenfield WI 53221-2057 |
| Practice Telephone | 4143257246 |
| Mailing Telephone | 4143257256 |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |
| Authorized Official Name | VISHAL LAL (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Telephone | 4143257246 |
| Is Organization Subpart | Y |
| Parent Organization Name | APM WISCONSIN MSO, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043579741 | Pain Centers of Wisconsin - Wauwatosa, LLC | Clinic/Center | 959 N Mayfair Rd, Milwaukee, WI 53226-3465 | 2012-05-15 |
| Street Address |
959 N MAYFAIR RD |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53226-3465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437796091 | Lisa Elliott | Nurse Practitioner | 959 N Mayfair Rd, Wauwatosa, WI 53226-3465 | 2019-12-03 |
| 1871955674 | Darshan B Patel | Anesthesiology | 959 N Mayfair Rd, Wauwatosa, WI 53226-3465 | 2016-03-22 |
| 1245653880 | Emily Mcclory | Registered Nurse | 959 N Mayfair Rd, Wauwatosa, WI 53226-3465 | 2014-02-03 |
| 1285077404 | Omar Dyara | Anesthesiology | 959 N Mayfair Rd, Wauwatosa, WI 53226-3465 | 2013-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861016404 | Active Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1233 N Mayfair Rd Ste 120, Wauwatosa, WI 53226-3255 | 2020-05-29 |
| 1548751688 | Athletic & Therapeutic Institute of Milwaukee LLC | Durable Medical Equipment & Medical Supplies | 11450 West Burleigh St, Suite 120, Wauwatosa, WI 53222-3216 | 2018-05-24 |
| 1093195596 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 11111 W Burleigh St, Wauwatosa, WI 53222-3211 | 2015-06-01 |
| 1710232715 | Independencefirst Mobility Store | Durable Medical Equipment & Medical Supplies | 12040 W Feerick St Ste N, Wauwatosa, WI 53222-2109 | 2012-07-17 |
| 1962768382 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3850 N 124th St, Wauwatosa, WI 53222-2104 | 2012-04-10 |
| 1649562778 | Aurora Advanced Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 2999 N. Mayfair Road, Suite 100, Wauwatosa, WI 53222 | 2011-05-09 |
| 1255564993 | Roundys Supermarkets Inc | Durable Medical Equipment & Medical Supplies | 1717 N Mayfair Rd, Wauwatosa, WI 53226-3019 | 2009-08-28 |
| 1124194246 | Sleepmed Therapies | Durable Medical Equipment & Medical Supplies | 2433 N Mayfair Rd, Wauwatosa, WI 53226-1406 | 2006-11-28 |
| 1437165875 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6600 W State St, Wauwatosa, WI 53213-2836 | 2006-07-31 |
| 1669487716 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 10800 W Capitol Dr, Wauwatosa, WI 53222-1109 | 2006-07-29 |
| Find all providers in WAUWATOSA | ||||
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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.