Active NPI
Sue M Fregien, MD
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Milwaukee, WI
National Provider Identifier
1457519613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- License
- 28626
- Practice address
- 2900 W Oklahoma Ave
Milwaukee, WI 53215-4330 - Phone
- (414) 649-1292
- NPI assigned
- May 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 28626 | WI | |
| Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 2083P0011X | 28626 | WI | Primary |
Addresses
Primary practice location
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Mailing address
2901 W Kinnickinnic River Pkwy Ste 309
Milwaukee, WI 53215-3660
Phone (414) 649-1292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457519613 | Medicaid | WI |
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 |
|---|---|---|---|
| 28626 | WI | MD | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1457519613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 W KINNICKINNIC RIVER PKWY STE 309",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153660",
"telephone_number": "414-649-1292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 W OKLAHOMA AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532154330",
"telephone_number": "414-649-1292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREGIEN",
"first_name": "SUE",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-23",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "28626",
"primary": false
},
{
"code": "2083P0011X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
"state": "WI",
"license": "28626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457519613",
"state": "WI"
}
],
"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 Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.