Individual provider Active NPI

Robert A. Palm, M.D.

  • Urology Physician
  • Franklin, WI
National Provider Identifier
1245254259
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
17725-020 Issued in WI
Practice address
4202 W Oakwood Park CT
# 200
Franklin, WI 53132-8131
Phone
(414) 423-5250
Fax
(414) 423-5256
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 17725-020 WI Primary

Addresses

Primary practice location

4202 W Oakwood Park CT
# 200
Franklin, WI 53132-8131

Mailing address

100 15TH Ave
#180
South Milwaukee, WI 53172-1160
Phone (414) 768-5430

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

LicenseStateTypeSpecialty
17725-020WIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Past Accepting new patients
Lakeshore Medical Clinic, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1245254259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 15TH AVE",
            "address_2": "#180",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721160",
            "telephone_number": "414-768-5430",
            "fax_number": "414-762-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 W OAKWOOD PARK CT",
            "address_2": "# 200",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531328131",
            "telephone_number": "414-423-5250",
            "fax_number": "414-423-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALM",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "17725-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.