Organization Active NPI

Aftab a Ansari, M.D., S.C.

  • Orthopaedic Hand Surgery Physician
  • Kenosha, WI
National Provider Identifier
1104009240
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
21598 Issued in WI
Legal business name
AFTAB A ANSARI, M.D., S.C.
Practice address
3535 30TH Ave
Suite 101B
Kenosha, WI 53144-1632
Phone
(262) 652-4878
NPI assigned
Dec 12, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Aftab A Ansari, M.D., S.C.NPI 1124182068
Title
Owner
Phone
(262) 652-4878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 21598 WI Primary

Addresses

Primary practice location

3535 30TH Ave
Suite 101B
Kenosha, WI 53144-1632

Mailing address

3535 30TH Ave
Suite 101B
Kenosha, WI 53144-1632
Phone (262) 652-4878

Other identifiers 1

IdentifierTypeStateIssuer
30186800MedicaidWI

National Provider Directory

National Provider Directory

Locations

3535 30th Ave
Ste 101B
Kenosha, WI 53144
Phone (262) 652-4878

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1104009240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 30TH AVE",
            "address_2": "SUITE 101B",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441632",
            "telephone_number": "262-652-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 30TH AVE",
            "address_2": "SUITE 101B",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441632",
            "telephone_number": "262-652-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFTAB A ANSARI, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ANSARI",
        "authorized_official_first_name": "AFTAB",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-652-4878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., S.C."
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "WI",
            "license": "21598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30186800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.