Individual provider Active NPI

Kieran Sultan-Lundeen, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • West Allis, WI
National Provider Identifier
1487014411
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
67021-20 Issued in WI
Practice address
8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone
(414) 328-7997
NPI assigned
Mar 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X TL0005900 CO
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 67021-20 WI Primary

Addresses

Primary practice location

8901 W Lincoln Ave
West Allis, WI 53227-2409

Mailing address

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 328-7997

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksultan190019@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170620002715 WI Practitioner - Pathology 6709154503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Pathologists SCGroup PAC ID 7315850682, 55 clinicians

Practice addresses (Care Compare)

8901 W Lincoln Ave
West Allis Memorial Hospital
West Allis, WI 53227-2409
Phone (414) 328-7950

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TL0005900COMDAnatomic Pathology & Clinical Pathology Physician
67021-20WIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Pathologists SC Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2017 Accepting new patients
A2Cl Services, LLC Current Accepting new patients

Locations

252 McHenry St
Burlington, WI 53105
Phone (262) 763-2411

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

13250 Washington Ave
Mount Pleasant, WI 53177
Phone (262) 799-8330

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

5000 Memorial Dr
Two Rivers, WI 54241
Phone (920) 794-5000

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: ksultan190019@direct.myadvocateaurora.org

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1487014411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272409",
            "telephone_number": "414-328-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272409",
            "telephone_number": "414-328-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTAN-LUNDEEN",
        "first_name": "KIERAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CO",
            "license": "TL0005900",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "67021-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksultan190019@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8901 W Lincoln Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "8901 W Lincoln Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.