Active NPI
Richard A Haas, MD PHD
- Pain Medicine Physician
- Mequon, WI
National Provider Identifier
1316987381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 21702020
- Practice address
- 1249 W Liebau Road
Suite 104
Mequon, WI 53092-3333 - Phone
- (262) 243-1244
- Fax
- (262) 243-1251
- NPI assigned
- Jun 7, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 21702020 | WI | |
| Pain Medicine Physician | 208VP0000X | 21702020 | WI | Primary |
Addresses
Primary practice location
1249 W Liebau Road
Suite 104
Mequon, WI 53092-3333
Mailing address
4555 West Schroeder Drive
Suite 170
Milwaukee, WI 53223
Phone (414) 365-3210
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30337800 | 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, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21702020 | WI | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206921600000",
"number": "1316987381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4555 WEST SCHROEDER DRIVE",
"address_2": "SUITE 170",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53223",
"telephone_number": "414-365-3210",
"fax_number": "414-365-3225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1249 W LIEBAU ROAD",
"address_2": "SUITE 104",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923333",
"telephone_number": "262-243-1244",
"fax_number": "262-243-1251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAS",
"first_name": "RICHARD",
"middle_name": "A",
"credential": "MD PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2008-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "21702020",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "WI",
"license": "21702020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30337800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.