Individual provider Active NPI

Daniel J Geenen, M.D.

  • Gastroenterology Physician
  • Milwaukee, WI
National Provider Identifier
1144297508
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
31528-020 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy Ste 1080
Milwaukee, WI 53215-3689
Phone
(414) 908-6615
Fax
(414) 385-2980
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 31528-020 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy Ste 1080
Milwaukee, WI 53215-3689

Mailing address

2801 W Kinnickinnic River Pkwy Ste 1080
Milwaukee, WI 53215-3689
Phone (414) 908-6615

Other identifiers 1

IdentifierTypeStateIssuer
32000300MedicaidWI

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
I20110409000036 WI Practitioner - Gastroenterology 8527970938

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31528-020WIMDGastroenterology Physician

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Camillus Home Health AgencyWauwatosa, WI, CCN 527164 Home health agency Corporate Officer May 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1144297508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 1080",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153689",
            "telephone_number": "414-908-6615",
            "fax_number": "414-385-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 1080",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153689",
            "telephone_number": "414-908-6615",
            "fax_number": "414-385-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEENEN",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "31528-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32000300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.