Individual provider Active NPI

Laurie A Kabins, M.D.

  • Anesthesiology Physician
  • Milwaukee, WI
National Provider Identifier
1114900677
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
38287-020 Issued in WI
Practice address
2301 N Lake Dr
Milwaukee, WI 53211-4508
Phone
(414) 291-1075
NPI assigned
Nov 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 38287-020 WI Primary

Addresses

Primary practice location

2301 N Lake Dr
Milwaukee, WI 53211-4508

Mailing address

4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 326-2378

Other identifiers 2

IdentifierTypeStateIssuer
050082958OtherRAIL ROAD MEDICARE
32292600MedicaidWI

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
I20050830000974 WI Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 0840221719 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38287-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Physicians Anesthesia Service, SC Anesthesiology CurrentSince Oct 1, 1999 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Sep 12, 2010 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Sep 12, 2010 Accepting new patients

Locations

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

Bin 88871
Milwaukee, WI 53288

2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932

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

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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.

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1114900677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-326-2378",
            "fax_number": "414-326-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114508",
            "telephone_number": "414-291-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABINS",
        "first_name": "LAURIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "38287-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "050082958",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32292600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.