Individual provider Active NPI

Maria Quevado Visaya, MD

  • Pediatrics Physician
  • Franklin, WI
National Provider Identifier
1487615431
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
41884020 Issued in WI
Practice address
9200 W Loomis Rd
Franklin, WI 53132-8887
Phone
(414) 529-9200
NPI assigned
Mar 30, 2006
Last updated
Oct 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 41884020 WI Primary

Addresses

Primary practice location

9200 W Loomis Rd
Franklin, WI 53132-8887

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (414) 529-9200

Other practice location 1

1502 S Layton Blvd
Milwaukee, WI 53215-1925
Phone (414) 291-2626

Other identifiers 1

IdentifierTypeStateIssuer
32617900MedicaidWI

Other names 1

  • Maria Fe Quevado Visaya Former name

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
I20050829000543 WI Practitioner - Pediatric Medicine 0244261329 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41884020WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Oct 1, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 9, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 9, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

9200 W Loomis Rd
Franklin, WI 53132
Phone (414) 529-9200

9200 W Loomis Rd
Ste 116
Franklin, WI 53132
Phone (414) 529-9200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1487615431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "414-529-9200"
        },
        {
            "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": "414-529-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1502 S LAYTON BLVD",
            "address_purpose": "LOCATION",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151925",
            "country_code": "US",
            "telephone_number": "414-291-2626",
            "fax_number": "414-931-0587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISAYA",
        "first_name": "MARIA",
        "middle_name": "QUEVADO",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "41884020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32617900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA FE",
            "last_name": "QUEVADO VISAYA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Franklin, WI

Sources for this page

Verify at the official NPI Registry.