Cardiothoracic Surgery Group, SC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2780-23 Issued in WI

Legal business name

CARDIOTHORACIC SURGERY GROUP, SC

Practice address

10150 W National Ave
Suite 190
West Allis, WI 53227-2145

Phone

(414) 271-5119

Fax

(414) 271-3756

NPI assigned

Jul 8, 2011

Organization subpart

No

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

Authorized official

Name

Robert McManus, M.D.

Title

M.D.

Phone

(414) 271-5119

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1114214350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 W NATIONAL AVE",
            "address_2": "SUITE 190",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272145",
            "telephone_number": "414-271-5119",
            "fax_number": "414-271-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 W NATIONAL AVE",
            "address_2": "SUITE 190",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272145",
            "telephone_number": "414-271-5119",
            "fax_number": "414-271-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOTHORACIC SURGERY GROUP, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "MCMANUS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "414-271-5119",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "2780-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in West Allis, WI
• Providers in West Allis, WI by specialty
• Surgical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.