NPIMap

Individual provider Active NPI

Eldon J Swenson, M.D.

  • General Practice Physician
  • Milwaukee, WI
National Provider Identifier
1063496131
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20106-20 Issued in WI
Practice address
620 S 76TH St
Suite 240
Milwaukee, WI 53214-1599
Phone
(414) 988-6350
NPI assigned
Dec 2, 2005
Last updated
Aug 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 20106-20 WI Primary

Addresses

Primary practice location

620 S 76TH St
Suite 240
Milwaukee, WI 53214-1599

Mailing address

620 S 76TH St
Suite 240
Milwaukee, WI 53214-1599
Phone (414) 988-6350

Other identifiers 1

IdentifierTypeStateIssuer
310013700MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
20106-20WIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen C. Becker, M.D., S.C. Past Accepting new patients
Metropolitan Anesthesiologists, S.C. Past Accepting new patients
Schaefer Medical SC Past Accepting new patients
David a. Thomas, M.D., S.C. Past Accepting new patients
Milwaukee Anes Consultants LTD Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1063496131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S 76TH ST",
            "address_2": "SUITE 240",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532141599",
            "telephone_number": "414-988-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S 76TH ST",
            "address_2": "SUITE 240",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532141599",
            "telephone_number": "414-988-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "ELDON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "20106-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310013700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.