NPIMap

Individual provider Active NPI

Robert Michael Kitsis, M.D.

  • Family Medicine Physician
  • Brown Deer, WI
National Provider Identifier
1336534403
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
66580 Issued in WI
Practice address
9252 N Green Bay Rd FL 2
Brown Deer, WI 53209
Phone
(414) 270-8150
Fax
(414) 270-8140
NPI assigned
Apr 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 66580 WI Primary

Addresses

Primary practice location

9252 N Green Bay Rd FL 2
Brown Deer, WI 53209

Mailing address

9252 N Green Bay Rd FL 2
Brown Deer, WI 53209-1104
Phone (414) 270-8150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180905000888 WI Practitioner - Family Practice 0941577092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9252 N Green Bay Rd
FL 2
Brown Deer, WI 53209-1104
Phone (414) 270-8150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66580WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Family Medicine Current Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Aug 15, 2018 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc Family Medicine CurrentSince Aug 15, 2018 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc Family Medicine Past Accepting new patients

Locations

9252 N Green Bay Rd
Fl 2
Milwaukee, WI 53209
Phone (414) 270-8150

2311 N Prospect Ave
Milwaukee, WI 53211
Phone (414) 319-3000

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1336534403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9252 N GREEN BAY RD FL 2",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091104",
            "telephone_number": "414-270-8150",
            "fax_number": "414-270-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9252 N GREEN BAY RD FL 2",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-270-8150",
            "fax_number": "414-270-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITSIS",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-05",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "66580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brown Deer, WI

Sources for this page

Verify at the official NPI Registry.