Individual provider Active NPI

Patricia Safavi, M.D.

  • Pediatrics Physician
  • Milwaukee, WI
National Provider Identifier
1275528523
Registry record updated May 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33835 Issued in WI
Practice address
2561 N 29TH St
Milwaukee, WI 53210-3116
Phone
(414) 264-5338
Fax
(414) 264-5625
NPI assigned
Sep 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 33835 WI Primary

Addresses

Primary practice location

2561 N 29TH St
Milwaukee, WI 53210-3116

Mailing address

2561 N 29TH St
Milwaukee, WI 53210-3116
Phone (414) 264-5338

Other identifiers 1

IdentifierTypeStateIssuer
31881500MedicaidWI

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
33835WIMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306108800000",
    "number": "1275528523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 N 29TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532103116",
            "telephone_number": "414-264-5338",
            "fax_number": "414-264-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2561 N 29TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532103116",
            "telephone_number": "414-264-5338",
            "fax_number": "414-264-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFAVI",
        "first_name": "PATRICIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2011-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "33835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31881500",
            "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 May 23, 2011; 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.