Individual provider Active NPI

Sheran S Mahatme, DO

  • Infectious Disease Physician
  • Milwaukee, WI
National Provider Identifier
1396711297
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
65183 Issued in WI
Practice address
9200 W Wisconsin Ave
Infectious Disease
Milwaukee, WI 53226-3522
Phone
(414) 805-6444
Fax
(414) 805-6702
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 0102201736 VA
Infectious Disease Physician 207RI0200X 2009-1453 NC
Internal Medicine Physician 207R00000X 0102201736 VA
Infectious Disease Physician 207RI0200X 65183 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Infectious Disease
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Infectious Disease
Milwaukee, WI 53226-3522
Phone (414) 805-6444

Other identifiers 18

IdentifierTypeStateIssuer
10003501OtherVASENTARA / OPTIMA INFECTIOUS DISEASE
010188075MedicaidVA
1396711297MedicaidWI
PAROtherVACIGNA
PAROtherVAUSA MANAGED CARE
-032OtherVATRICARE/CHAMPUS
186800OtherVAANTHEM
5901553MedicaidNC
154EEOtherNCBC/BS NC
PAROtherVAVIRGINIA PREMIER HEALTH
PAROtherVAVIRGINIA HEALTH NETWORK
PAROtherVACORVEL/CORCARE
01553OtherNCBC/BS
PAROtherVAMULTIPLAN
PAROtherVAFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
10003793OtherVASENTARA/INF DIS PCP
9140289OtherVAUHC/MAMSI
PAROtherVAAETNA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160412000637 WI Practitioner - Infectious DiseasePractitioner - Internal Medicine 3577582659 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1225SDMDClinical Social Worker
0102201736VAMDInternal Medicine Physician
2009-1453NCMDInfectious Disease Physician
65183WIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients

Locations

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: smahatmemd195153@direct.froedtert.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1396711297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "INFECTIOUS DISEASE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6444",
            "fax_number": "414-805-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "INFECTIOUS DISEASE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6444",
            "fax_number": "414-805-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHATME",
        "first_name": "SHERAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0102201736",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": "2009-1453",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102201736",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WI",
            "license": "65183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA / OPTIMA INFECTIOUS DISEASE",
            "identifier": "10003501",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010188075",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396711297",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "-032",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "186800",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901553",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NC",
            "identifier": "154EE",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL/CORCARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "01553",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/INF DIS PCP",
            "identifier": "10003793",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC/MAMSI",
            "identifier": "9140289",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PAR",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.