Organization Active NPI

Medical Genetics Institute, S.C.

  • Ph.D. Medical Genetics
  • Glendale, WI
National Provider Identifier
1437319142
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
21932-020 Issued in WI
Legal business name
MEDICAL GENETICS INSTITUTE, S.C.
Practice address
2311 W Good Hope Rd
Glendale, WI 53209-2735
Phone
(414) 228-0100
Fax
(414) 228-8774
NPI assigned
Jun 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Mrs. Maria M De Elejalde, M.S., R.N.
Title
Vice President
Phone
(414) 228-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical GeneticsGroup: 193400000X SINGLE SPECIALTY GROUP 170100000X 21932-020 WI Primary

Addresses

Primary practice location

2311 W Good Hope Rd
Glendale, WI 53209-2735

Mailing address

2311 W Good Hope Rd
Glendale, WI 53209-2735
Phone (414) 228-0100

National Provider Directory

National Provider Directory

Locations

2311 W Good Hope Rd
Glendale, WI 53209
Phone (414) 228-0100

3267 S 16th St
Ste 206
Milwaukee, WI 53215
Phone (414) 385-7004

1626 W Fond du Lac Ave
Ste 111
Milwaukee, WI 53205
Phone (414) 287-1000

1626 W Fond du Lac Ave
Ste 110
Milwaukee, WI 53205
Phone (414) 228-0100

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1437319142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 W GOOD HOPE RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532092735",
            "telephone_number": "414-228-0100",
            "fax_number": "414-228-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 W GOOD HOPE RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532092735",
            "telephone_number": "414-228-0100",
            "fax_number": "414-228-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL GENETICS INSTITUTE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "DE ELEJALDE",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "414-228-0100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S., R.N."
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "WI",
            "license": "21932-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.