Individual provider Active NPI

Alexandra H Fairchild, M.D.

  • Vascular & Interventional Radiology Physician
  • Milwaukee, WI
National Provider Identifier
1255658464
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
63752 Issued in WI
Practice address
9200 W Wisconsin Ave
Department of Radiology
Milwaukee, WI 53226-3522
Phone
(414) 805-3750
Fax
(414) 259-9290
NPI assigned
Apr 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 63752 WI Primary
Diagnostic Radiology Physician 2085R0202X 63752 WI

Addresses

Primary practice location

9200 W Wisconsin Ave
Department of Radiology
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Department of Radiology
Milwaukee, WI 53226-3522
Phone (414) 805-3750

Other identifiers 1

IdentifierTypeStateIssuer
1255658464MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160718001131 WI Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 0345488250 Reassigns benefits to 2 organizations
I20200706002721 LA Practitioner - Interventional Radiology 0345488250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Medical College of Wisconsin, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2000 Canal St
New Orleans, LA 70112-3018
Phone (504) 702-3000

2832 Burdette St
New Orleans, LA 70125-2514
Phone (504) 866-2741

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince May 1, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 7, 2016 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince May 1, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 1, 2016 Accepting new patients

Locations

478 S Johnson St
Fl 6
New Orleans, LA 70112
Phone (504) 412-1819

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1255658464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-3750",
            "fax_number": "414-259-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-3750",
            "fax_number": "414-259-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCHILD",
        "first_name": "ALEXANDRA",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": "63752",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "63752",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255658464",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.