Organization Active NPI

S T Sy MD SC

  • Pediatrics Physician
  • Greenfield, WI
National Provider Identifier
1114020633
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
19332020 Issued in WI
Legal business name
S T SY MD SC
Practice address
4666 S 35TH St
Greenfield, WI 53221
Phone
(414) 281-0400
Fax
(414) 281-0402
NPI assigned
Sep 7, 2006
Last updated
Mar 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

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

Authorized official

Name
Dr. Santiago T Sy, MD
Title
President
Phone
(414) 281-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 19332020 WI Primary

Addresses

Primary practice location

4666 S 35TH St
Greenfield, WI 53221

Mailing address

4666 S 35TH St
Greenfield, WI 53221
Phone (414) 281-0400

Other identifiers 1

IdentifierTypeStateIssuer
309677MedicaidWI

National Provider Directory

National Provider Directory

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": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332720000000",
    "number": "1114020633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4666 S 35TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53221",
            "telephone_number": "414-281-0400",
            "fax_number": "414-281-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4666 S 35TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53221",
            "telephone_number": "414-281-0400",
            "fax_number": "414-281-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S T SY MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2012-03-26",
        "status": "A",
        "authorized_official_last_name": "SY",
        "authorized_official_first_name": "SANTIAGO",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-281-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "19332020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309677",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; 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.