Active NPI
Peter Michael Medved, M.D.
- Otolaryngology Physician
- Franklin, WI
National Provider Identifier
1427062439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 24579
- Practice address
- 9200 W Loomis Rd
Franklin, WI 53132-8887 - Phone
- (414) 529-9330
- Fax
- (414) 529-9331
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 24579 | WI | Primary |
Addresses
Primary practice location
9200 W Loomis Rd
Franklin, WI 53132-8887
Mailing address
9200 W Loomis Rd
Franklin, WI 53132-8887
Phone (414) 529-9330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30756000 | Medicaid | WI | |
| 24579 | Other | WI | STATE LICENSE # |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24579 | WI | MD | Otolaryngology Physician |
Interoperability endpoints
- pmedved@medvedent.directglo.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1427062439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W LOOMIS RD",
"city": "FRANKLIN",
"state": "WI",
"postal_code": "531328887",
"telephone_number": "414-529-9330",
"fax_number": "414-529-9331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W LOOMIS RD",
"city": "FRANKLIN",
"state": "WI",
"postal_code": "531328887",
"telephone_number": "414-529-9330",
"fax_number": "414-529-9331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDVED",
"first_name": "PETER",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "WI",
"license": "24579",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30756000",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "24579",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Franklin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.