Individual provider Active NPI

Kevin James Dahlman, M.D.

  • Pediatrics Physician
  • Delafield, WI
National Provider Identifier
1063590255
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
49905 Issued in WI
Practice address
3195 Hillside Dr
Delafield, WI 53018-2189
Phone
(262) 646-9960
Fax
(262) 646-9961
NPI assigned
Nov 2, 2006
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 49905 WI Primary

Addresses

Primary practice location

3195 Hillside Dr
Delafield, WI 53018-2189

Mailing address

999 N 92ND St
Wauwatosa, WI 53226-4875
Phone (414) 266-2000

Other identifiers 1

IdentifierTypeStateIssuer
35336800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080908000273 WI Practitioner - Pediatric Medicine 3274609789 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49905WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. Pediatrics CurrentSince Sep 1, 2008 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Sep 1, 2008 Accepting new patients
Lakeshore Medical Clinic, LLC PastSince Jan 1, 2020 Accepting new patients
Aurora Medical Group, Inc. PastSince Jan 1, 2020 Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

215 Washington St
Grafton, WI 53024
Phone (262) 375-3700

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

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, 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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1063590255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 N 92ND ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264875",
            "telephone_number": "414-266-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 HILLSIDE DR",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182189",
            "telephone_number": "262-646-9960",
            "fax_number": "262-646-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLMAN",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "49905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35336800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delafield, WI

Sources for this page

Verify at the official NPI Registry.