Active NPI
Peter W Messer, MD
- Dermatology Physician
- Milwaukee, WI
National Provider Identifier
1205881653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 21402
- Practice address
- 2801 W KK River Pkwy
#135
Milwaukee, WI 53215-3669 - Phone
- (414) 385-8600
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 21402 | WI | Primary |
Addresses
Primary practice location
2801 W KK River Pkwy
#135
Milwaukee, WI 53215-3669
Mailing address
4315 W River Lake Dr
Mequon, WI 53092-4856
Phone (414) 242-1116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30161700 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21402 | WI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1205881653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4315 W RIVER LAKE DR",
"city": "MEQUON",
"state": "WI",
"postal_code": "530924856",
"telephone_number": "414-242-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 W KK RIVER PKWY",
"address_2": "#135",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153669",
"telephone_number": "414-385-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MESSER",
"first_name": "PETER",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WI",
"license": "21402",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30161700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.