Individual provider Active NPI

David W Grambow, MD

  • Cardiovascular Disease Physician
  • Milwaukee, WI
National Provider Identifier
1235178674
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
28836 Issued in WI
Practice address
2350 N Lake Dr
Suite 400
Milwaukee, WI 53211-4528
Phone
(414) 271-1633
Fax
(414) 271-5071
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 28836 WI Primary

Addresses

Primary practice location

2350 N Lake Dr
Suite 400
Milwaukee, WI 53211-4528

Mailing address

4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 271-1633

Other identifiers 1

IdentifierTypeStateIssuer
31921000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040128000596 WI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2860395845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Vanderbilt University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outreach Community Health Centers IncGroup PAC ID 1355247735, shared by 9 NPIs, 53 clinicians

Practice addresses (Care Compare)

1004 N 10TH St
Milwaukee, WI 53233-1423
Phone (414) 765-0606

10101 S 27TH St
Franklin, WI 53132-7209
Phone (414) 325-4700

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300

13133 N Port Washington Rd
Suite G06
Mequon, WI 53097-2421
Phone (262) 243-8371

2301 N Lake Dr
Milwaukee, WI 53211-4508

2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1000

2350 N Lake Dr
Milwaukee, WI 53211-4528

3056 S Kinnickinnic Ave
Milwaukee, WI 53207-2583
Phone (414) 769-4900

375 W Riverwoods Pkwy
Glendale, WI 53212-1080
Phone (414) 326-1800

475 W River Woods Pkwy
Glendale, WI 53212-1081
Phone (414) 961-6800

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28836WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee, Inc Current Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Jan 1, 2007 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Jan 1, 2007 Accepting new patients

Locations

7395 Solutions Ctr
Chicago, IL 60677

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

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

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

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

2350 N Lake Dr
Ste 400
Milwaukee, WI 53211
Phone (414) 270-1633

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

3056 S Kinnickinnic Ave
Ste 300
Milwaukee, WI 53207
Phone (414) 294-0971

2315 N Lake Dr
Ste 613
Milwaukee, WI 53211
Phone (414) 271-1633

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

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

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

10950 W Capitol Dr
Wauwatosa, WI 53222
Phone (414) 464-4460

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

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1235178674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-271-1633",
            "fax_number": "414-271-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "address_2": "SUITE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-271-1633",
            "fax_number": "414-271-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMBOW",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "28836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31921000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.