Individual provider Active NPI

Vernon Dale Casterline, M.D.

  • Dermatology Physician
  • Greenfield, WI
National Provider Identifier
1104887223
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25757-020 Issued in WI
Practice address
2923 W Layton Ave
Greenfield, WI 53221-2626
Phone
(414) 281-0712
Fax
(414) 281-3466
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25757-020 WI Primary
Clinical & Laboratory Dermatological Immunology Physician 207NI0002X 25757-020 WI
Procedural Dermatology Physician 207NS0135X 25757-020 WI
MOHS-Micrographic Surgery Physician 207ND0101X 25757-020 WI
Dermatopathology Physician 207ND0900X 25757-020 WI
Pediatric Dermatology Physician 207NP0225X 25757-020 WI

Addresses

Primary practice location

2923 W Layton Ave
Greenfield, WI 53221-2626

Mailing address

2923 W Layton Ave
Greenfield, WI 53221-2626
Phone (414) 281-0712

Other identifiers 1

IdentifierTypeStateIssuer
30842200MedicaidWI

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
I20101116000717 WI Practitioner - Dermatology 3476624925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25757-020WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Layton Avenue Dermatology Associates, S.C. Dermatology CurrentSince Sep 15, 2003 Accepting new patients

Locations

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

2923 W Layton Ave
Milwaukee, WI 53221
Phone (414) 281-0712

2424 S 90th St
Ste 410
West Allis, WI 53227
Phone (414) 328-8050

10401 W Lincoln Ave
Ste 104
West Allis, WI 53227
Phone (414) 328-8050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1104887223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212626",
            "telephone_number": "414-281-0712",
            "fax_number": "414-281-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2923 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212626",
            "telephone_number": "414-281-0712",
            "fax_number": "414-281-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTERLINE",
        "first_name": "VERNON",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "25757-020",
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "WI",
            "license": "25757-020",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WI",
            "license": "25757-020",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WI",
            "license": "25757-020",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WI",
            "license": "25757-020",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "WI",
            "license": "25757-020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30842200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.