Individual provider Active NPI

Michael Vineburg, PHARMD

  • Pharmacist
  • Cedarburg, WI
National Provider Identifier
1265038012
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18722-40 Issued in WI
Practice address
N54W6135 Mill St Ste 300
Cedarburg, WI 53012-2050
Phone
(262) 375-0010
Fax
(262) 375-0080
NPI assigned
Dec 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18722-40 WI Primary

Addresses

Primary practice location

N54W6135 Mill St Ste 300
Cedarburg, WI 53012-2050

Mailing address

8650 N Fielding Rd
Bayside, WI 53217-2426
Phone (920) 246-3580

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
18722-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cedarburg Prescription Center, Inc CurrentSince Dec 13, 2020 Accepting new patients
Plex Health Inc Past Accepting new patients
Cedarburg Prescription Center Inc PastSince Dec 13, 2020 Accepting new patients

Locations

N54W6135 Mill St
Ste 300
Cedarburg, WI 53012
Phone (262) 375-0010

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.

NPI Registry JSON

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1265038012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 N FIELDING RD",
            "city": "BAYSIDE",
            "state": "WI",
            "postal_code": "532172426",
            "telephone_number": "920-246-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N54W6135 MILL ST STE 300",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122050",
            "telephone_number": "262-375-0010",
            "fax_number": "262-375-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINEBURG",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "18722-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.