Elisabeth T Madagame, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

30455 Issued in WI

Practice address

4855 S Moorland Rd
New Berlin, WI 53151-7494

Phone

(262) 432-7599

Fax

(262) 432-7694

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1295750016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 S MOORLAND RD",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517494",
            "telephone_number": "262-432-7599",
            "fax_number": "262-432-7694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 Plaza Dr",
            "address_2": "Suite 2200",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544014158",
            "country_code": "US",
            "telephone_number": "715-847-2311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADAGAME",
        "first_name": "ELISABETH",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "30455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295750016",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.