NPIMap

Organization Active NPI

Burton a Waisbren MD SC

  • Infectious Disease Physician
  • Wauwatosa, WI
National Provider Identifier
1497958839
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
11016 Issued in WI
Legal business name
BURTON A WAISBREN MD SC
Practice address
3077 N Mayfair Rd
Ste 100
Wauwatosa, WI 53222-4305
Phone
(414) 771-5900
Fax
(414) 771-4908
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Burton A. Waisbren I, M.D.
Title
President
Phone
(414) 771-5900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 11016 WI
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X 11016 WI Primary

Addresses

Primary practice location

3077 N Mayfair Rd
Ste 100
Wauwatosa, WI 53222-4305

Mailing address

3077 N Mayfair Rd
Ste 100
Wauwatosa, WI 53222-4305
Phone (414) 771-5900

Other identifiers 5

IdentifierTypeStateIssuer
131754002293OtherHUMANA
11016OtherWILICENSE NUMBER
2784552OtherAETNA MEDICARE
0004299533OtherAETNA
1317540002293OtherHUMANA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1497958839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 N MAYFAIR RD",
            "address_2": "STE 100",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224305",
            "telephone_number": "414-771-5900",
            "fax_number": "414-771-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 N MAYFAIR RD",
            "address_2": "STE 100",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224305",
            "telephone_number": "414-771-5900",
            "fax_number": "414-771-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURTON A WAISBREN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WAISBREN",
        "authorized_official_first_name": "BURTON",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-771-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "11016",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WI",
            "license": "11016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "131754002293",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "11016",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA MEDICARE",
            "identifier": "2784552",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004299533",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1317540002293",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.