Renato S Azcueta, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25896 Issued in WI

Practice address

7220 W National Ave
West Allis, WI 53214

Phone

(414) 257-8500

Fax

(414) 257-8505

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 7, 2023.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1346258902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-647-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 W NATIONAL AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-257-8500",
            "fax_number": "414-257-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZCUETA",
        "first_name": "RENATO",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "25896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30636500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aurora Pharmacy Inc
• Aurora Pharmacy Inc
• Aurora Pharmacy, Inc.
• Avail Home Care LLC
• Destiny Averhart, LPN
• B&P Transportation Service
• Patricia A Bachhuber, MD
• Back 2 Action Chiropractic LLC
• Erin L Bailey, RN
• Katherine Baker

• All providers in West Allis, WI
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.