Active NPI
Bruce P Himelstein, MD
- Pediatrics Physician
- Milwaukee, WI
National Provider Identifier
1275622599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 43283
- Practice address
- 3070 S 51St Street
Suite 601
Milwaukee, WI 53210-1661 - Phone
- (414) 447-3470
- Fax
- (414) 447-3471
- NPI assigned
- Oct 12, 2006
- Last updated
- Sep 16, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 43283 | WI | Primary |
Addresses
Primary practice location
3070 S 51St Street
Suite 601
Milwaukee, WI 53210-1661
Mailing address
3070 S 51St Street
Suite 601
Milwaukee, WI 53210-1661
Phone (414) 447-3470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34078200 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 43283 | WI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284595200000",
"number": "1275622599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3070 S 51ST STREET",
"address_2": "SUITE 601",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532101661",
"telephone_number": "414-447-3470",
"fax_number": "414-447-3471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3070 S 51ST STREET",
"address_2": "SUITE 601",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532101661",
"telephone_number": "414-447-3470",
"fax_number": "414-447-3471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIMELSTEIN",
"first_name": "BRUCE",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2010-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "43283",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34078200",
"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 Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.