Sujan Fernando

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

54297 Issued in WI

Practice address

9200 W Wisconsin Ave
Department of Radiology
Milwaukee, WI 53226-3522

Phone

(414) 805-3750

Fax

(414) 259-9290

NPI assigned

Jul 16, 2008

Last updated

Jun 25, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

University of Missouri, Kansas City, School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Memorial MRI and Diagnostic LLCGroup PAC ID 6507859568, 77 clinicians

Radiology Associates of the Fox Valley SCGroup PAC ID 0446152748, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177
• SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088
• Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
• Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327
• Southwest Health Center Hospital, Platteville, WI, CCN 521354

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfernandomd159416@direct.froedtert.com

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

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment Care Compare group NPD
• Memorial MRI and Diagnostic LLC

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1912989120
  Medicare reassignment Care Compare group NPD
• Radiology Associates of the Fox Valley, SC

  • Diagnostic Radiology Physician
  • Neenah, WI
  • NPI 1477539443
  Medicare reassignment Care Compare group
• Froedtert Manitowoc Medical Group, LLC

  dba Froedtert Northeast Medical Group

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• Akumin Imaging Texas LLC

  • Radiology Clinic/Center
  • El Paso, TX
  • NPI 1235771205
  NPD
• Preferred Imaging of Amarillo, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Amarillo, TX
  • NPI 1235544669
  NPD
• Preferred Imaging of Austin LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Austin, TX
  • NPI 1437542818

  Diagnostic Radiology

  NPD
• Preferred Imaging of Corinth, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Corinth, TX
  • NPI 1831328392
  NPD
• Preferred Imaging of Frisco, LLC

  • Radiology Clinic/Center
  • Frisco, TX
  • NPI 1881028397

  Diagnostic Radiology

  NPD
• Preferred Imaging of Grapevine/Colleyville, LLC

  • Radiology Clinic/Center
  • Grapevine, TX
  • NPI 1518040369
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Agnesian Healthcare, Inc

  dba SSM Health St Agnes Hospital Fond Du Lac

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541
  Care Compare affiliation
• Froedtert Memorial Lutheran Hospital, Inc.

  dba CDI-Froedtert Memorial Lutheran Hospital

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation
• Southwest Health Center, Inc

  • Critical Access Hospital
  • Platteville, WI
  • NPI 1831279793
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc

  dba ThedaCare Medical Center Orthopedics, Spine, and Pain

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1740920909
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1497119218
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1689038408
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  dba WI Veterans Village Physical Therapy

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1831773589
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1902832306
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  dba ThedaCare Medical Center - Fond Du Lac

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1912721002
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  dba ThedaCare Medical Center - Oshkosh

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1912880329
  Care Compare affiliation
• Waupun Memorial Hospital

  dba SSM Health Waupun Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Waupun, WI
  • NPI 1528046737
  Care Compare affiliation
• Waupun Memorial Hospital

  dba SSM Health Waupun Memorial Hospital

  • Critical Access Hospital
  • Waupun, WI
  • NPI 1548248644
  Care Compare affiliation

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1023272200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-3750",
            "fax_number": "414-259-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-3750",
            "fax_number": "414-259-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "SUJAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME115385",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "54297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008911900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristina Fernandez Gonzalez de la Vega, MD
• Amanda Marie Fernandez, LCSW
• Angela Rose Fernandez, MSW, APSW
• Jerrett Jay Fernandez, SAC-IT, CNA
• Pablo A Fernandez, DENTIST
• Lindsey Ferr
• Brandy R Ferrara, DC
• Lydia R Ferraro
• Alysia Ferreira, COTA
• Sarah N Ferreira, CCC-SLP

• Diagnostic Radiology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.