Active NPI
Leyla Hamizadeh
- Pediatrics Physician
- New Berlin, WI
National Provider Identifier
1508081258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 52652
- Practice address
- 4855 S Moorland Rd
Suite 150
New Berlin, WI 53151-7494 - Phone
- (414) 425-5660
- Fax
- (414) 425-9803
- NPI assigned
- Apr 16, 2007
- Last updated
- Jul 1, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 52652 | WI | Primary |
Addresses
Primary practice location
4855 S Moorland Rd
Suite 150
New Berlin, WI 53151-7494
Mailing address
9000 W Wisconsin Ave
Ms 958
Milwaukee, WI 53226-4874
Phone (414) 266-7615
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52652 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Medical Group | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- lhamizadeh7475@direct.chw.org
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, 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": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1508081258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "MS 958",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-7615",
"fax_number": "414-266-1721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 S MOORLAND RD",
"address_2": "SUITE 150",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531517494",
"telephone_number": "414-425-5660",
"fax_number": "414-425-9803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMIZADEH",
"first_name": "LEYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "52652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.