Benjamin Landgraf

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

66515-20 Issued in WI

Practice address

12635 W Bluemound Rd
Brookfield, WI 53005-8004

Phone

(414) 258-0606

Fax

(414) 258-1953

NPI assigned

May 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Children'S Medical Group

  • Pediatrics Physician
  • Glendale, WI
  • NPI 1134394471
  NPD (past)

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1053723130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12635 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058004",
            "telephone_number": "414-258-0606",
            "fax_number": "414-258-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12635 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058004",
            "telephone_number": "414-258-0606",
            "fax_number": "414-258-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDGRAF",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "66515-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053723130",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashanti Lambrecht
• Mary Lambright
• Malinee Lamont
• Landers Psychotherapy Services LLC
• Landgraf Chiropractic, LLC
• Patricia Hope Landgraf, D.C.
• Andrea Marie Lange, D.C.
• Jessica Lange, M.A., LPC
• Calvin Jay Langmade, PSY.D.
• Sergiy Larin, MD

• Pediatrics Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.