Individual provider Active NPI

Irum Ziauddin, PA-C

  • Medical Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1386686905
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4097-23 Issued in WI
Practice address
3201 S 16TH St Ste 2015
Milwaukee, WI 53215-4532
Phone
(414) 649-3810
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4097-23 WI Primary

Addresses

Primary practice location

3201 S 16TH St Ste 2015
Milwaukee, WI 53215-4532

Mailing address

PO Box 70520
Milwaukee, WI 53207-0520
Phone (262) 240-0841

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180406002223 WI Practitioner - Physician Assistant 0143310524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

2311 N Prospect Ave
Milwaukee, WI 53211-4445
Phone (414) 319-3000

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Aug 20, 2019 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Aug 20, 2019 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients

Locations

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

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

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 1

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1386686905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70520",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532070520",
            "telephone_number": "262-240-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S 16TH ST STE 2015",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154532",
            "telephone_number": "414-649-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIAUDDIN",
        "first_name": "IRUM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "4097-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.