Active NPI
Gary Seabrook, MD
- Vascular Surgery Physician
- Milwaukee, WI
National Provider Identifier
1407809148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 25424
- Practice address
- 9200 W Wisconsin Ave
Vascular Surgery
Milwaukee, WI 53226-3522 - Phone
- (414) 805-9160
- Fax
- (414) 805-9170
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 25424 | WI | Primary |
Addresses
Primary practice location
9200 W Wisconsin Ave
Vascular Surgery
Milwaukee, WI 53226-3522
Mailing address
9200 W Wisconsin Ave
Vascular Surgery
Milwaukee, WI 53226-3522
Phone (414) 805-9160
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002000134Z | Other | HUMANA | |
| 1407809148 | Medicaid | WI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411603200000",
"number": "1407809148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"address_2": "VASCULAR SURGERY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-9160",
"fax_number": "414-805-9170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"address_2": "VASCULAR SURGERY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-9160",
"fax_number": "414-805-9170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEABROOK",
"first_name": "GARY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2014-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WI",
"license": "25424",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "002000134Z",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1407809148",
"state": "WI"
}
],
"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 Sep 25, 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.