Organization Active NPI

Milestone Pediatrics, SC

  • Pediatrics Physician
  • Waukesha, WI
National Provider Identifier
1417607136
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MILESTONE PEDIATRICS, SC
Practice address
20611 Watertown Rd Ste D&E
Waukesha, WI 53186-1871
Phone
(262) 256-0676
NPI assigned
Mar 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Authorized official

Name
Amy M Lautz, MDNPI 1437125424
Title
Owner / President
Phone
(414) 241-5730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X

Addresses

Primary practice location

20611 Watertown Rd Ste D&E
Waukesha, WI 53186-1871

Mailing address

20611 Watertown Rd Ste D & E
Waukesha, WI 53186-1871
Phone (622) 256-0676

Other identifiers 1

IdentifierTypeStateIssuer
1437125424OtherWINPI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2262663Milestone Pediatrics SC20611 Watertown Rd Ste D, Waukesha, WI 53186Certificate of waiverJun 15, 2028

National Provider Directory

National Provider Directory

Locations

20611 Watertown Rd
Ste De
Waukesha, WI 53186
Phone (262) 256-0676

20611 Watertown Rd
Ste D
Waukesha, WI 53186
Phone (262) 782-7021

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1417607136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20611 WATERTOWN RD STE D & E",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861871",
            "telephone_number": "622-256-0676",
            "fax_number": "262-205-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20611 WATERTOWN RD STE D&E",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861871",
            "telephone_number": "262-256-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE PEDIATRICS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "LAUTZ",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "414-241-5730",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437125424",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.