Individual provider Active NPI

Larry H Sherkow, MD

  • Diagnostic Radiology Physician
  • West Bend, WI
National Provider Identifier
1003816042
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20178 Issued in WI
Practice address
5760 W Lake Dr
West Bend, WI 53095-8447
Phone
(262) 297-1267
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 20178 WI Primary

Addresses

Primary practice location

5760 W Lake Dr
West Bend, WI 53095-8447

Mailing address

5760 W Lake Dr
West Bend, WI 53095-8447
Phone (262) 297-1267

Other identifiers 1

IdentifierTypeStateIssuer
31371100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Milwaukee, S.C. Diagnostic Radiology Past Accepting new patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology Past Accepting new patients
Advanced Healthcare SC Past Accepting new patients
Aurora Advanced Healthcare, Inc. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1003816042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5760 W LAKE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958447",
            "telephone_number": "262-297-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5760 W LAKE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958447",
            "telephone_number": "262-297-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERKOW",
        "first_name": "LARRY",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "20178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31371100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.