DEXTER R REBANCOS (NPI# 1801974399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801974399 |
| Entity Type | Individual |
| Full Name | DEXTER R REBANCOS |
| Credential | MD |
| Practice Address |
5900 S. Lake Drive Cudahy WI 53110-3171 |
| Mailing Address |
100-15th Ave. Ste 180 South Milwaukee WI 53172-1160 |
| Practice Telephone | 4144894190 |
| Practice Fax Number | 4144894015 |
| Mailing Telephone | 4147685430 |
| Mailing Fax Number | 4147624225 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 33762-020 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
5900 S. LAKE DRIVE |
| City | CUDAHY |
| State | WI |
| Zip Code | 53110-3171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457329534 | Nicholas N Armstrong | Surgery | 5900 S. Lake Drive, Cudahy, WI 53110-3171 | 2006-03-14 |
| 1558435123 | Stephen C Lamberton | Family Medicine | 5900 S. Lake Drive, Lakeshore Medical Clinic, Cudahy, WI 53110-3171 | 2006-11-17 |
| 1578641155 | Thomas J Broihier | Internal Medicine | 5900 S. Lake Drive, Lakeshore Medical Clinic, Cudahy, WI 53110-3171 | 2006-11-01 |
| 1689780462 | Jack Avak Tertadian | Internal Medicine | 5900 S. Lake Drive, Cudahy, WI 53110 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1497191357 | Kristel Roebbeke | Occupational Therapist | 4157 W College Ave, Milwaukee, WI 53110 | 2013-05-20 |
| 1568684058 | City of Cudahy | Case Management | 5050 South Lake Drive, Cudahy, WI 53110 | 2007-05-03 |
| 1104854363 | Mathew George Mathai | Internal Medicine | 5900 S. Lake Dr., Cudahy, WI 53110 | 2006-06-28 |
| 1174917199 | Alyssa Kaleta | Internal Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2015-03-27 |
| 1740546829 | Fatima Ali | Family Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2012-04-03 |
| 1609003508 | Elizabeth A Vissat | Podiatrist | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2009-06-18 |
| 1366616864 | Miguel A Aguilera | Anesthesiology | 5900 S Lake Dr, Cudahy, WI 53110 | 2008-04-15 |
| 1235355983 | Aurora Health Care Metro, Inc. | Clinic/Center | 5900 S Lake Drive, Cudahy, WI 53110 | 2007-04-18 |
| 1114005618 | Manila Sodhi | Internal Medicine | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2006-11-01 |
| Find all providers in zip 53110 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407942311 | Jose N Prieto | Family Medicine | 4566 Florence Ave Ste 2, Cudahy, CA 90201-4346 | 2006-10-05 |
| 1043235153 | Nikki Allen | Family Medicine | 4580 S Nicholson Ave, Cudahy, WI 53110-1360 | 2006-07-12 |
| 1306208392 | Julie Navarro | Family Medicine | 7825 Atlantic Ave, Cudahy, CA 90201 | 2016-03-28 |
| 1740546829 | Fatima Ali | Family Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2012-04-03 |
| 1932491842 | Sharareh Shabafrooz | Family Medicine | 6901 Atlantic Ave, Cudahy, CA 90201-3646 | 2011-05-11 |
| 1255647889 | Paola A Case | Family Medicine | 7825 Atlantic Ave, Cudahy, CA 90201-5022 | 2010-08-20 |
| 1558435123 | Stephen C Lamberton | Family Medicine | 5900 S. Lake Drive, Lakeshore Medical Clinic, Cudahy, WI 53110-3171 | 2006-11-17 |
| 1518045038 | Rebecca L Scerpella | Family Medicine | 5900 S. Lake Dr., Lakeshore Medical Clinic, Cudahy, WI 53110-3171 | 2006-11-01 |
| 1316025844 | Sacha Ramirez | Family Medicine | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2006-11-01 |
| 1386722817 | Ami Prag | Family Medicine | 5900 S Lake Drive, #100, Cudahy, WI 53110 | 2006-11-01 |
| Find all providers in CUDAHY | ||||
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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.