Individual provider Active NPI

Andrew L Cardoni, M.D.

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1285720375
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
48686-020 Issued in WI
Practice address
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone
(414) 649-6588
Fax
(770) 237-1723
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 48686-020 WI Primary

Addresses

Primary practice location

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330

Mailing address

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6588

Other identifiers 2

IdentifierTypeStateIssuer
34799400MedicaidWI
006OtherWIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070713000794 WI Practitioner - Emergency Medicine 0941300339 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48686-020WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Associates LLP Emergency Medicine CurrentSince Oct 1, 2009 Accepting new patients
Lake Country Emergency Physicians Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients

Locations

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
#5
Waukesha, WI 53188
Phone (262) 928-2475

Interoperability endpoints

  • Direct secure messaging: acardoni9484@direct.phci.org

Organizations & group practices 2

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1285720375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-649-6588",
            "fax_number": "770-237-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-649-6588",
            "fax_number": "770-237-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONI",
        "first_name": "ANDREW",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "48686-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34799400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "006",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.