Active NPI
Sheran S Mahatme, DO
- Infectious Disease Physician
- Milwaukee, WI
National Provider Identifier
1396711297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 65183
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10003501 | Other | VA | SENTARA / OPTIMA INFECTIOUS DISEASE |
| 010188075 | Medicaid | VA | |
| 1396711297 | Medicaid | WI | |
| PAR | Other | VA | CIGNA |
| PAR | Other | VA | USA MANAGED CARE |
| -032 | Other | VA | TRICARE/CHAMPUS |
| 186800 | Other | VA | ANTHEM |
| 5901553 | Medicaid | NC | |
| 154EE | Other | NC | BC/BS NC |
| PAR | Other | VA | VIRGINIA PREMIER HEALTH |
| PAR | Other | VA | VIRGINIA HEALTH NETWORK |
| PAR | Other | VA | CORVEL/CORCARE |
| 01553 | Other | NC | BC/BS |
| PAR | Other | VA | MULTIPLAN |
| PAR | Other | VA | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY |
| 10003793 | Other | VA | SENTARA/INF DIS PCP |
| 9140289 | Other | VA | UHC/MAMSI |
| PAR | Other | VA | AETNA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1225 | SD | MD | Clinical Social Worker |
| 0102201736 | VA | MD | Internal Medicine Physician |
| 2009-1453 | NC | MD | Infectious Disease Physician |
| 65183 | WI | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Internal Medicine | Current | 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
- 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.
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.