HIGHLANDER DERMATOLOGY LLC (NPI# 1790216554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790216554 |
| Entity Type | Organization |
| Organization Name | HIGHLANDER DERMATOLOGY LLC |
| Practice Address |
2607 N Grandview Blvd Ste 125 Waukesha WI 53188-1686 |
| Practice Telephone | 4144550919 |
| Mailing Telephone | 2622904540 |
| Mailing Fax Number | 2622292220 |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | DR. BRADLEY T.J. STRAKA (OWNER) |
| Authorized Official Telephone | 4148992385 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
H059290 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | SOLE OWNER NPI: 1326031964. HIGHLANDER LLC TIN:========= | 1326031964 | 01 |
| Street Address |
2607 N GRANDVIEW BLVD STE 125 |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-1686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326031964 | Bradley Theodore John Straka | Dermatology | 2607 N Grandview Blvd, Ste 125, Waukesha, WI 53188-1686 | 2005-08-30 |
| 1508409806 | Kendra Bittner | Counselor | 2607 N Grandview Blvd, Waukesha, WI 53188-1686 | 2019-10-21 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 53188 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609040146 | Waukesha Eye Associates, S.c. | Clinic/Center | 1111 Delafield St, Suite 314, Waukesha, WI 53188-3417 | 2008-04-16 |
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|---|---|---|---|---|
| 1518446558 | Northwoods Family Physical Medicine of Wisconsin, S.c. | Clinic/Center | 2360a Duck Creek Pkwy Ste 2, Green Bay, WI 54303-3377 | 2018-08-10 |
| 1104222330 | Premier Cardiovascular Institute of Wisconsin LLC | Clinic/Center | 1309 S 54th St, Milwaukee, WI 53214-3404 | 2014-11-17 |
| 1629498522 | Asana Health & Wellness LLC | Clinic/Center | 2372 S Oneida St, Green Bay, WI 54304-5256 | 2014-04-18 |
| 1467792457 | Vein Care Associates S.c. | Clinic/Center | 215 Corporate Drive, Suite H, Beaver Dam, WI 53916-3124 | 2013-02-27 |
| 1447532403 | Lavender Lotus Acupuncture LLC | Clinic/Center | 130 Gregor St, Waterloo, WI 53594-1224 | 2011-09-15 |
| 1043501356 | Steven Victor Bittorf | Clinic/Center | 2505 Parkwood Dr, Green Bay, WI 54304-1956 | 2011-04-21 |
| 1881927812 | Gail A Weinand | Clinic/Center | 203 Schiek Plz, Rhinelander, WI 54501-3364 | 2009-09-09 |
| 1932368685 | Center for Stomach & Intestinal Disorders Ltd | Clinic/Center | 2300 N Mayfair Rd Ste 725, Wauwatosa, WI 53226-1533 | 2008-06-07 |
| 1568641439 | Daniel L. Gauerkei Dba Broadway Vision Center | Clinic/Center | 815 W Fulton St, Suite 103, Waupaca, WI 54981-1405 | 2007-10-29 |
| 1174723084 | Bruns Chiropractic Office Sc | Clinic/Center | 1429 North Ave, Sheboygan, WI 53083-4760 | 2007-07-19 |
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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.