Individual provider Active NPI

Brian Jay Silverstein, MD

  • Internal Medicine Physician
  • Lake Geneva, WI
National Provider Identifier
1184601015
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
43143 Issued in WI
Practice address
W3329 Burr Oak Dr
Lake Geneva, WI 53147-4323
Phone
(847) 271-9609
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43143 WI Primary

Addresses

Primary practice location

W3329 Burr Oak Dr
Lake Geneva, WI 53147-4323

Mailing address

1000 Elm Ridge Dr
Glencoe, IL 60022-1129
Phone (443) 602-4016

Other practice location 1

1000 Elm Ridge Dr
Glencoe, IL 60022-1129
Phone (443) 602-4016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43143WIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1184601015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ELM RIDGE DR",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221129",
            "telephone_number": "443-602-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3329 BURR OAK DR",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474323",
            "telephone_number": "847-271-9609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Elm Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Glencoe",
            "state": "IL",
            "postal_code": "600221129",
            "country_code": "US",
            "telephone_number": "443-602-4016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SILVERSTEIN",
        "first_name": "BRIAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "43143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.