Active NPI
Siamak Arassi, MD
- Addiction Medicine (Internal Medicine) Physician
- Brookfield, WI
National Provider Identifier
1083680417
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jun 20, 2023.
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Internal Medicine) Physician
- License
- 41661-21
- Practice address
- 19115 W Capitol Dr
117
Brookfield, WI 53045 - Phone
- (262) 781-0240
- Fax
- (262) 373-0148
- NPI assigned
- Feb 26, 2006
- Last updated
- Aug 22, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | 41661-21 | WI | Primary |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 41661 | WI |
Addresses
Primary practice location
19115 W Capitol Dr
117
Brookfield, WI 53045
Mailing address
19115 W Capitol Dr
117
Brookfield, WI 53045-2754
Phone (262) 781-0240
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32527500 | Medicaid | WI | |
| 1083680417 | Other | WI | BLUE SHIELD |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41661 | WI | MD | Addiction Medicine (Family Medicine) Physician |
| 41661-21 | WI | MD | Addiction Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Past | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients | |
| Green Bay Emergency Medicine Services S.C. | Past | Accepting new patients | |
| Med Alliance S.C. | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1083680417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19115 W CAPITOL DR",
"address_2": "117",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530452754",
"telephone_number": "262-781-0240",
"fax_number": "262-373-0148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19115 W CAPITOL DR",
"address_2": "117",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "53045",
"telephone_number": "262-781-0240",
"fax_number": "262-373-0148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARASSI",
"first_name": "SIAMAK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-26",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RA0401X",
"taxonomy_group": "",
"desc": "Internal Medicine, Addiction Medicine",
"state": "WI",
"license": "41661-21",
"primary": true
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "WI",
"license": "41661",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32527500",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "1083680417",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.