NPIMap

Individual provider Active NPI

Surendra Patel, M.D.

  • Internal Medicine Physician
  • Waukesha, WI
National Provider Identifier
1265748404
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56944 Issued in WI
Practice address
N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone
(262) 875-5070
Fax
(866) 384-9486
NPI assigned
Aug 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 56944 WI Primary
Internal Medicine Physician 207R00000X 125056488 IL

Addresses

Primary practice location

N20W22961 Watertown Rd
Waukesha, WI 53186-1306

Mailing address

N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone (262) 875-5070

Other practice location 1

W180N8085 Town Hall Rd
Internal Medicine Hospitalist Division
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

Other identifiers 1

IdentifierTypeStateIssuer
1265748404MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120618000561 WI Practitioner - Internal Medicine 1850555145 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Medical SC 118 clinicians
Maple Medical SC 25 clinicians
Froedtert Andthe Medical College of Wisconsin Community Physicians Inc 1,265 clinicians

Practice addresses (Care Compare)

1451 Cleveland Ave
Waukesha, WI 53186-3876
Phone (262) 547-2123

N20W22961 Watertown Rd
Waukesha, WI 53186-1306
Phone (262) 875-5070

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002
Phone (262) 255-2500

Hospital & facility affiliations

  • Brighton Hospice Wisconsin Hospice, Brookfield, WI, CCN 521603
  • Holistic Hospice Hospice, Greenfield, WI, CCN 521601
  • Aurora at Home Hospice, Green Bay, WI, CCN 521567
  • Aurora at Home Hospice, Wauwatosa, WI, CCN 521528
  • North Shore at Home Hospice, Glendale, WI, CCN 521608
  • Community Memorial Hospital Hospital, Menomonee Falls, WI, CCN 520103
  • St Josephs Community Hospital West Bend Hospital, West Bend, WI, CCN 520063
  • Aspirus Tomahawk Hospital Hospital, Tomahawk, WI, CCN 521313
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Froedtert Community Hospital Hospital, New Berlin, WI, CCN 520213
  • Lasata Care Center Nursing home, Cedarburg, WI, CCN 525537
  • Heritage Health Services Nursing home, Port Washington, WI, CCN 525586
  • Resolve at West Allis Respiratory and Rehab Nursing home, West Allis, WI, CCN 525108
  • St Paul Elder Services, Inc Nursing home, Kaukauna, WI, CCN 525617
  • Evergreen Health Center Nursing home, Oshkosh, WI, CCN 525647

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125056488ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Medical SC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Maple Medical SC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Southpointe Care and Rehab Center LLC PastSince Aug 7, 2024 Accepting new patients

Locations

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

1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

1451 Cleveland Ave
Waukesha, WI 53186
Phone (262) 547-2123

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

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

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

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

Interoperability endpoints

  • Direct secure messaging: spatelmd84207@direct.froedtert.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Allis Care CenterWest Allis, WI, CCN 525108 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF		 Oct 1, 2024
Oct 1, 2024
County of OzaukeeCedarburg, WI, CCN 525537 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 31, 2023
Oct 31, 2023
Complete Care at SouthpointeGreenfield, WI, CCN 525604 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 7, 2024
Aug 7, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1265748404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861306",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W180N8085 Town Hall Rd",
            "address_2": "INTERNAL MEDICINE HOSPITALIST DIVISION",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-251-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SURENDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "56944",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125056488",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265748404",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.