Individual provider Active NPI

Harry A Tagalakis, MD

  • Pain Medicine (Anesthesiology) Physician
  • Greenfield, WI
National Provider Identifier
1386611093
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
48287 Issued in WI
Practice address
4131 W. Loomis Rd.
Ste 300
Greenfield, WI 53221-2059
Phone
(414) 325-7246
Fax
(414) 325-3770
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 48287 WI Primary

Addresses

Primary practice location

4131 W. Loomis Rd.
Ste 300
Greenfield, WI 53221-2059

Mailing address

4131 W. Loomis Rd.
Ste 300
Greenfield, WI 53221-2059
Phone (414) 325-7246

Other identifiers 1

IdentifierTypeStateIssuer
34675900MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
48287WIMDPain Medicine (Anesthesiology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1386611093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W. LOOMIS RD.",
            "address_2": "STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212059",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 W. LOOMIS RD.",
            "address_2": "STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212059",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGALAKIS",
        "first_name": "HARRY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WI",
            "license": "48287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34675900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.