Gregory Alan Ekbom, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20232020 Issued in WI

Practice address

10400 W North Avenue
#480
Milwaukee, WI 53226-2425

Phone

(414) 778-6670

Fax

(414) 778-6672

NPI assigned

Mar 20, 2007

Last updated

Jul 6, 2011By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Milwaukee General & Vascular Surgery SC

  • Surgery Physician
  • Milwaukee, WI
  • NPI 1508988239
  NPD (past) Authorized official

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1326163304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 309",
            "address_2": "#480",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530720309",
            "telephone_number": "262-366-1595",
            "fax_number": "414-778-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 W NORTH AVENUE",
            "address_2": "#480",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262425",
            "telephone_number": "414-778-6670",
            "fax_number": "414-778-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKBOM",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "20232020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020014187",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21261700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayleigh Rose Eisold, MS, LPC-IT
• Richard Allen Eison, LPN
• James A Eiting
• Usama Ejaz
• Monique Shantel Ejimbe, RN
• Ay Bike Eke
• Nwadiuto Chikaodili Ekeh
• Oghenerukevwe Bethany Ekeh
• Adele Castillo Eklund
• Jamey Elizabeth Eklund, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.