Individual provider Active NPI

Chaitanya Swaroop Puvvada, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Milwaukee, WI
National Provider Identifier
1417744616
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2301 N Lake Dr
Columbia St. Mary'S Hospital
Milwaukee, WI 53211
Phone
(414) 737-6170
NPI assigned
Apr 22, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2301 N Lake Dr
Columbia St. Mary'S Hospital
Milwaukee, WI 53211

Mailing address

2400 W. Villard Avenue
Ms. Sandra Olsen
Milwaukee, WI 53209
Phone (414) 527-8415

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)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1417744616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W. VILLARD AVENUE",
            "address_2": "MS. SANDRA OLSEN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-527-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N LAKE DR",
            "address_2": "COLUMBIA ST. MARY'S HOSPITAL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53211",
            "telephone_number": "414-737-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUVVADA",
        "first_name": "CHAITANYA SWAROOP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 22, 2025; 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.