Individual provider Active NPI

Antonio De Villa Salud II, MD

  • Pulmonary Disease Physician
  • Milwaukee, WI
National Provider Identifier
1093811655
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
50455 Issued in WI
Practice address
2323 N Lake Dr
Room 4250
Milwaukee, WI 53211-4508
Phone
(414) 291-1468
Fax
(414) 278-2843
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 50455 WI Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 50455 WI

Addresses

Primary practice location

2323 N Lake Dr
Room 4250
Milwaukee, WI 53211-4508

Mailing address

788 N Jefferson St
Suite 300
Milwaukee, WI 53202-3718
Phone (414) 272-8950

Other identifiers 1

IdentifierTypeStateIssuer
1093811655MedicaidWI

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
I20070720000890 WI Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 7113952839 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Medical College of Wisconsin, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Madison Medical Affiliates IncGroup PAC ID 5991606337, 86 clinicians

Practice addresses (Care Compare)

12831 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 643-1300

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300

13125 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7408

2301 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 291-1000

2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (262) 243-7408

788 N Jefferson St
Suite 401
Milwaukee, WI 53202-3718
Phone (414) 226-4020

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Milwaukee Critical Care and Pulmonary Associates SC Critical Care Medicine CurrentSince Mar 1, 2018 Accepting new patients
Madison Medical Affiliates, Inc. CurrentSince May 1, 2007 Accepting new patients
Midwest Critical Care SC Critical Care Medicine CurrentSince Jan 1, 2023 Accepting new patients

Locations

7423 Solutions Ctr
Chicago, IL 60677

19475 W North Ave
Brookfield, WI 53045
Phone (262) 780-4000

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

13133 N Port Washington Rd
Ste 104
Mequon, WI 53097
Phone (262) 243-5000

13133 N Port Washington Rd
Ste G01
Mequon, WI 53097
Phone (262) 243-2500

2323 N Lake Dr
Rm 4250
Milwaukee, WI 53211
Phone (414) 291-1468

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

788 N Jefferson St
Ste 401
Milwaukee, WI 53202
Phone (414) 226-4020

3201 S 16th St
Ste 2015
Milwaukee, WI 53215
Phone (262) 240-0841

788 N Jefferson St
Ste 300
Milwaukee, WI 53202
Phone (414) 272-8950

2350 N Lake Dr
Ste 305
Milwaukee, WI 53211
Phone (414) 298-7171

3803 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-3973

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1093811655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST",
            "address_2": "SUITE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023718",
            "telephone_number": "414-272-8950",
            "fax_number": "414-225-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 N LAKE DR",
            "address_2": "ROOM 4250",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114508",
            "telephone_number": "414-291-1468",
            "fax_number": "414-278-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALUD",
        "first_name": "ANTONIO",
        "middle_name": "DE VILLA",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "50455",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WI",
            "license": "50455",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093811655",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.