Wisconsin Phlebology Medical Group SC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WISCONSIN PHLEBOLOGY MEDICAL GROUP SC

Practice address

10614 N Port Washington Rd
Mequon, WI 53092-5013

Phone

(262) 834-0123

NPI assigned

May 24, 2006

Last updated

May 4, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathan Amoruso

Title

Sr VP Revenue

Phone

(847) 593-8460

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 7

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.

• Stuart M Feldman, D.O.

  • Emergency Medicine Physician
  • Milwaukee, WI
  • NPI 1760434633
  Medicare reassignment NPD
• Wan-Lin Horng, M.D.

  • Surgery Physician
  • Glendale, AZ
  • NPI 1619037405

  WI

  Medicare reassignment NPD
• Serik Tursunaliev, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1780175349

  WI

  Medicare reassignment NPD
• Umang Patel, M.D.

  • Family Medicine Physician
  • Mansfield, TX
  • NPI 1710305735

  Phlebology

  NPD
• Boyd Eric Erdman, M.D.

  • Phlebology Physician
  • Waunakee, WI
  • NPI 1508989716
  NPD (past)
• Paul Henry Cheatum, MD

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1952367534

  Phlebology

  NPD (past)
• Aaron Cohen, MD

  • Vascular Surgery Physician
  • Buffalo Grove, IL
  • NPI 1679533764
  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1295780492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1602",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600651602",
            "telephone_number": "847-593-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10614 N PORT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925013",
            "telephone_number": "262-834-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN PHLEBOLOGY MEDICAL GROUP SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "AMORUSO",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "SR VP REVENUE",
        "authorized_official_telephone_number": "847-593-8460"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wisconsin Dental Group, S.C. (ForwardDental Mequon)
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• Wisconsin Family and Sports Chiropractic, LLC
• Wisconsin Interventional Pain Physicians, SC
• Wisconsin Michigan Physicians, SC
• Wisconsin Psychiatric Services, LTD
• Wisconsin Radiology Specialists, S C
• Wise Management Inc.
• Lorraine Witt, PA
• Natalia G Woehl, RD.CD

• Surgery Physician in Mequon, WI
• Providers in Mequon, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.