Individual provider Active NPI

Debra Berridge, M.D.

  • Diagnostic Radiology Physician
  • Mequon, WI
National Provider Identifier
1194707968
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
30649 Issued in WI
Practice address
10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078
Phone
(414) 434-0461
NPI assigned
Nov 17, 2005
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 30649 WI Primary

Addresses

Primary practice location

10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078

Mailing address

10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TN, IL3 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050603000967 WI Practitioner - Diagnostic Radiology 0749223402 Reassigns benefits to 5 organizations
I20210929001052 TN Practitioner - Diagnostic Radiology 0749223402 Reassigns benefits to 1 organization
I20240210000537 IL Practitioner - Diagnostic Radiology 0749223402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30649WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Current Accepting new patients
Precision Radiology - Illinois LTD CurrentSince Feb 1, 2023 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Apr 1, 2010 Accepting new patients
Wisconsin Health Fund CurrentSince Jun 21, 2011 Accepting new patients
Wisconsin Radiology Specialists, S C CurrentSince Oct 1, 2001 Accepting new patients
Middle Tennessee Imaging LLC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Apr 1, 2010 Accepting new patients
Premier Radiology Wisconsin, LLC Diagnostic Radiology CurrentSince Mar 1, 2020 Accepting new patients

Locations

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

28 White Bridge Pike
Ste 111
Nashville, TN 37205
Phone (615) 986-6153

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

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

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

12800 N Port Washington Rd
Mequon, WI 53097
Phone (262) 243-3655

13133 N Port Washington Rd
Mequon, WI 53097
Phone (262) 243-5850

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

500 W Brown Deer Rd
Ste 202
Milwaukee, WI 53217

6200 W Bluemound Rd
Milwaukee, WI 53213
Phone (414) 479-3668

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998

830 E Green Bay Ave
Saukville, WI 53080
Phone (262) 284-7117

830 E Green Bay Ave
Ste 103
Saukville, WI 53080
Phone (262) 268-0606

1414 N Taylor Dr
Ste 210
Sheboygan, WI 53081
Phone (262) 243-2500

10945 N Port Washington Rd
Ste 201
Thiensville, WI 53092
Phone (262) 478-0301

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

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

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

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1194707968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD STE 201",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD STE 201",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925078",
            "telephone_number": "414-434-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRIDGE",
        "first_name": "DEBRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "30649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.