Individual provider Active NPI

Melissa A Kalt, MD

  • Internal Medicine Physician
  • Waukesha, WI
National Provider Identifier
1326011701
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
43263 Issued in WI
Practice address
2315 E Moreland Blvd
Waukesha, WI 53186-2909
Phone
(262) 532-5700
Fax
(262) 532-5701
NPI assigned
Feb 8, 2006
Last updated
Jan 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43263 WI Primary
Pediatrics Physician 208000000X 43263 WI

Addresses

Primary practice location

2315 E Moreland Blvd
Waukesha, WI 53186-2909

Mailing address

2315 E Moreland Blvd
Waukesha, WI 53186-2909
Phone (262) 532-5700

Other identifiers 1

IdentifierTypeStateIssuer
1326011701MedicaidWI

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
I20060523000087 WI Practitioner - Pediatric MedicinePractitioner - Internal Medicine 1052322427 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43263WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 1, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine CurrentSince Jun 1, 2013 Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Aug 1, 2008 Accepting new patients
Prohealth Medical Group Inc Internal Medicine Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

2315 E Moreland Blvd
Waukesha, WI 53186
Phone (262) 532-5700

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1326011701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 E MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862909",
            "telephone_number": "262-532-5700",
            "fax_number": "262-532-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862909",
            "telephone_number": "262-532-5700",
            "fax_number": "262-532-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALT",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "43263",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "43263",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326011701",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.