Individual provider Active NPI

Jefferson Narciso Calimlim, M.D.

  • Otolaryngology Physician
  • Milwaukee, WI
National Provider Identifier
1245369933
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
22310 Issued in WI
Practice address
3267 S 16TH St
Suite 101
Milwaukee, WI 53215-4500
Phone
(414) 384-3838
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 22310 WI Primary

Addresses

Primary practice location

3267 S 16TH St
Suite 101
Milwaukee, WI 53215-4500

Mailing address

3267 S 16TH St
Suite 101
Milwaukee, WI 53215-4500
Phone (414) 384-3838

Other identifiers 1

IdentifierTypeStateIssuer
30256300MedicaidWI

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22310WIMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245369933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3267 S 16TH ST",
            "address_2": "SUITE 101",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154500",
            "telephone_number": "414-384-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3267 S 16TH ST",
            "address_2": "SUITE 101",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154500",
            "telephone_number": "414-384-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIMLIM",
        "first_name": "JEFFERSON",
        "middle_name": "NARCISO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "22310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30256300",
            "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 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.