NPIMap

Organization Active NPI

Waukesha Surgical Specialists, S.C.

  • Surgery Physician
  • Waukesha, WI
National Provider Identifier
1295776649
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
WAUKESHA SURGICAL SPECIALISTS, S.C.
Practice address
1111 Delafield St
Suite 209
Waukesha, WI 53188-3417
Phone
(262) 542-0444
Fax
(262) 542-8214
NPI assigned
Jun 9, 2006
Last updated
Apr 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Christopher B Davies, MDNPI 1437146099
Title
President
Phone
(262) 542-0444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1111 Delafield St
Suite 209
Waukesha, WI 53188-3417

Mailing address

1111 Delafield St
Suite 209
Waukesha, WI 53188-3403
Phone (262) 542-0444

Other identifiers 1

IdentifierTypeStateIssuer
32665700MedicaidWI

Other names 1

  • aukesha General & Vascular Surgery, S.C. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429001209 WI Part B Supplier - Clinic/Group Practice 6406843424 Receives reassigned benefits from 19 practitioners
Practice locations: Oconomowoc, WI; Waukesha, WI; Watertown, WI; Mukwonago, WI; Brookfield, WI

National Provider Directory

National Provider Directory

Locations

1111 Delafield St
Ste 209
Waukesha, WI 53188
Phone (414) 542-0444

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1295776649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "SUITE 209",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883403",
            "telephone_number": "262-542-0444",
            "fax_number": "262-542-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "SUITE 209",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883417",
            "telephone_number": "262-542-0444",
            "fax_number": "262-542-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKESHA SURGICAL SPECIALISTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-542-0444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32665700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "aukesha General & Vascular Surgery, S.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "aukesha General & Vascular Surgery, S.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.