David E Melbye, M.D.
Individual provider Active NPI Pediatrics Physician · Fox Point, WI
NPI 1487640918 · NPPES record last updated Sep 16, 2020
Key facts
- NPI
- 1487640918
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 46303 (WI)
- Practice address
- 7950 N Port Washington Rd
Fox Point, WI 53217-3131 - Phone
- (414) 228-0099
- Fax
- (414) 540-1065
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050329000475 | WI | Practitioner - Pediatric Medicine | 8921054370 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46303 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Medical Group Inc | Pediatrics | Current |
Accepting new patients |
| The Medical College of Wisconsin, Inc. | Past | Accepting new patients | |
| Children'S Medical Group | Pediatrics | Past |
Accepting new patients |
Locations
6373 N Jean Nicolet Rd
Ste 100
Glendale, WI 53217
Phone (414) 228-0099
11035 W Forest Home Ave
Hales Corners, WI 53130
Phone (414) 425-5660
9000 W Wisconsin Ave
#958
Wauwatosa, WI 53226
Phone (414) 266-7615
Interoperability endpoints
- dmelbye12266@direct.chw.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 46303 | WI | Yes |
Addresses
Primary practice location
7950 N Port Washington Rd
Fox Point, WI 53217-3131
Mailing address
7950 N Port Washington Rd
Fox Point, WI 53217-3131
Phone (414) 228-0099
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487640918 | Medicaid | WI |
Other providers in Fox Point, WI
- Petrus V Lindeque
- Michelle M Linsmeier
- Adrienne Loukopoulos
- Emily Lubar
- Juliette Martin Thomas
- Emily Ann Miller
- Moore Blessings
- Kelly Morello
- Mary K Murphy
- Myeyedr Optometry of Wisconsin, LLC
All providers in Fox Point, WI · Pediatrics Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.