Mustafa Syed Badrudduja, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

51809 Issued in WI

Practice address

6308 8TH Ave
Suite 3050
Kenosha, WI 53143-5031

Phone

(262) 654-7002

Fax

(262) 654-6822

NPI assigned

Mar 6, 2007

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

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

Specialty

General Surgery

Education

Wright State University Boonshoft School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jandali Surgical Associates, S.C.Group PAC ID 2860461811, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score

90.88 of 100Reported as group

Quality

100

Improvement activities

40

Cost

69.6

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbadrudduja344679@direct.froedtert.com
• FHIR API: https://fhir4.healow.com/fhir/r4/GGJBBD
• FHIR API: https://fhir4.healow.com/fhir/r4/GGJBBD/Endpoint/GGJBBD

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.

• Jandali Surgical Associates, S.C.

  • Surgery Physician
  • Pleasant Prairie, WI
  • NPI 1528101433

  Surgery, WI

  Medicare reassignment Care Compare group NPD

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

• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1083744486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "address_2": "SUITE 3050",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-654-7002",
            "fax_number": "262-654-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "address_2": "SUITE 3050",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-654-7002",
            "fax_number": "262-654-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADRUDDUJA",
        "first_name": "MUSTAFA",
        "middle_name": "SYED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.087678",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "51809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pushparanee Babusukumar, MD
• Back-in-Action Physical Therapy Center of Kenosha, LTD.
• Alyssa Backhaus
• Rachel K Backhaut, PT
• Marissa Bacon, PT, DPT
• Amy T Bahr, LPC
• Laura Bailey
• Antigona Bajraktari, APSW
• Chloe Baker Wachowiacz, RDH
• Annette Bale, APRN

• All providers in Kenosha, WI
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.