NPIMap

Organization Active NPI

Noemi a Prieto MD SC

Doing business as Southeastern Pediatric & Adolescent Medicine

  • Primary Care Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1447365614
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
26529 Issued in WI
Legal business name
NOEMI A PRIETO MD SC
Doing business as
Southeastern Pediatric & Adolescent Medicine
Practice address
8532 W Capitol Dr
Milwaukee, WI 53222-1827
Phone
(414) 463-6640
Fax
(414) 463-6743
NPI assigned
Aug 20, 2006
Last updated
Jul 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
Noemi A Prieto, MDNPI 1013147222
Title
President
Phone
(414) 463-6640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 26529 WI Primary

Addresses

Primary practice location

8532 W Capitol Dr
Milwaukee, WI 53222-1827

Mailing address

1126 S. 70TH St
N500
Milwaukee, WI 53214
Phone (414) 455-4780

Other identifiers 4

IdentifierTypeStateIssuer
31529500MedicaidWI
32466900MedicaidWI
34437400MedicaidWI
30718400MedicaidWI

Other names 1

  • Southeastern Pediatric & Adolescent Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Noemi a Prieto MD SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1447365614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 S. 70TH ST",
            "address_2": "N500",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-455-4780",
            "fax_number": "414-475-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8532 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221827",
            "telephone_number": "414-463-6640",
            "fax_number": "414-463-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOEMI A PRIETO MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "PRIETO",
        "authorized_official_first_name": "NOEMI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-463-6640",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "26529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31529500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32466900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34437400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30718400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Pediatric & Adolescent Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 16, 2009; 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.