Individual provider Active NPI

David K. Dueker, M.D.

  • Ophthalmology Physician
  • Milwaukee, WI
National Provider Identifier
1417049222
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
49798 Issued in WI
Practice address
925 N 87TH St
Department of Ophthalmology
Milwaukee, WI 53226-4812
Phone
(414) 456-2020
Fax
(414) 456-6300
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 49798 WI Primary

Addresses

Primary practice location

925 N 87TH St
Department of Ophthalmology
Milwaukee, WI 53226-4812

Mailing address

925 N 87TH St
Department of Ophthalmology
Milwaukee, WI 53226-4812
Phone (414) 456-2020

Other identifiers 1

IdentifierTypeStateIssuer
1417049222MedicaidWI

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1417049222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N 87TH ST",
            "address_2": "DEPARTMENT OF OPHTHALMOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264812",
            "telephone_number": "414-456-2020",
            "fax_number": "414-456-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N 87TH ST",
            "address_2": "DEPARTMENT OF OPHTHALMOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264812",
            "telephone_number": "414-456-2020",
            "fax_number": "414-456-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUEKER",
        "first_name": "DAVID",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "49798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417049222",
            "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 Nov 1, 2012; 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.