Neetu Chakravarti, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

49080-020 Issued in WI

Practice address

1320 Wisconsin Ave
Racine Family Medicine (Medical College of Wisconsin)
Racine, WI 53403-1978

Phone

(262) 687-5656

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194883843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 N MAIN ST APT 226",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534025302",
            "telephone_number": "262-681-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN AVE",
            "address_2": "RACINE FAMILY MEDICINE (MEDICAL COLLEGE OF WISCONSIN)",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031978",
            "telephone_number": "262-687-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRAVARTI",
        "first_name": "NEETU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "49080-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catholic Charities of the Archdiocese of Milwaukee Inc
• Randall C. Cech, RN
• Centerwell Certified Healthcare Corp.
• Gina Marie Cerminara, LPC
• Chad Novasic PT LTD
• Dewita Latrice Chambers, LPN
• Amy Sprague Champeau, MS, LMFT
• Michael Leo Champeau, LCSW
• Lijuan Chen
• Edward Cheng, DDS

• Family Medicine Physician in Racine, WI
• Providers in Racine, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.