NPIMap

Organization Active NPI

Ctvsa Wisconsin S.C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Kenosha, WI
National Provider Identifier
1225318090
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
CTVSA WISCONSIN S.C.
Practice address
6308 8TH Ave
Suite 3060
Kenosha, WI 53143-5031
Phone
(262) 656-2700
Fax
(262) 656-3672
NPI assigned
Aug 24, 2011
Last updated
Aug 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Authorized official

Name
Dr. Patroklos Steven Pappas, M.D.NPI 1265427942
Title
President
Phone
(708) 346-4040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X WI
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X WI Primary

Addresses

Primary practice location

6308 8TH Ave
Suite 3060
Kenosha, WI 53143-5031

Mailing address

4400 W 95TH St
Suite 205
Oak Lawn, IL 60453-2654
Phone (708) 346-4040

National Provider Directory

National Provider Directory

Locations

3801 Spring St
Ste 400
Mount Pleasant, WI 53405
Phone (262) 687-4015

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1225318090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST",
            "address_2": "SUITE 205",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532654",
            "telephone_number": "708-346-4040",
            "fax_number": "708-346-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "address_2": "SUITE 3060",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-656-2700",
            "fax_number": "262-656-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CTVSA WISCONSIN S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "PAPPAS",
        "authorized_official_first_name": "PATROKLOS",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-346-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.

Verify at the official NPI Registry.