NPIMap

Organization Active NPI

Wisconsin Dermatology LLC

  • Dermatology Physician
  • Mount Pleasant, WI
National Provider Identifier
1174200562
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
WISCONSIN DERMATOLOGY LLC
Practice address
5439 Durand Ave Ste 100
Mount Pleasant, WI 53406-5058
Phone
(262) 898-9000
NPI assigned
Jun 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Dr. Jonathan Saigh, DCNPI 1699134437
Title
President
Phone
(262) 898-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

5439 Durand Ave Ste 100
Mount Pleasant, WI 53406-5058

Mailing address

5439 Durand Ave Ste 100
Mount Pleasant, WI 53406-5058
Phone (262) 898-9000

National Provider Directory

National Provider Directory

Locations

5439 Durand Ave
Ste 100
Mount Pleasant, WI 53406
Phone (262) 898-9000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1174200562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 DURAND AVE STE 100",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065058",
            "telephone_number": "262-898-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5439 DURAND AVE STE 100",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065058",
            "telephone_number": "262-898-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "SAIGH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-898-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.