Individual provider Active NPI

Theresa M Richter, MD

  • Anesthesiology Physician
  • Wauwatosa, WI
National Provider Identifier
1093755902
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25406 Issued in WI
Practice address
10900 W Potter Rd
Wauwatosa, WI 53226-3424
Phone
(262) 787-6737
Fax
(262) 782-6040
NPI assigned
Jun 8, 2006
Last updated
Sep 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25406 WI Primary

Addresses

Primary practice location

10900 W Potter Rd
Wauwatosa, WI 53226-3424

Mailing address

225 S Executive Dr
Brookfield, WI 53005-4257
Phone (262) 787-6737

Other identifiers 1

IdentifierTypeStateIssuer
34115300MedicaidWI

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
I20040510001365 WI Practitioner - Anesthesiology 8527057017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Anesthesia and Pain Specialists SCGroup PAC ID 2365598406, 11 clinicians

Practice addresses (Care Compare)

3111 W Rawson Ave
Franklin, WI 53132-9417
Phone (414) 761-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25406WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Anesthesia and Pain Specialists SC Anesthesiology CurrentSince Dec 1, 2019 Accepting new patients
Brookfield Anesthesiologists, S.C. Anesthesiology CurrentSince Mar 4, 2020 Accepting new patients
Chad Novasic PT LTD Past Accepting new patients

Locations

225 S Executive Dr
Brookfield, WI 53005
Phone (262) 787-4026

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

3111 W Rawson Ave
Franklin, WI 53132
Phone (414) 325-4300

7401 104th Ave
Kenosha, WI 53142
Phone (262) 697-1006

10900 W Potter Rd
Wauwatosa, WI 53226
Phone (414) 774-9227

Interoperability endpoints

  • Direct secure messaging: trichter88678@direct.phci.org

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1093755902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S EXECUTIVE DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054257",
            "telephone_number": "262-787-6737",
            "fax_number": "262-782-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 W POTTER RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263424",
            "telephone_number": "262-787-6737",
            "fax_number": "262-782-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "25406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34115300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.