Charles F Kidd, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

46512020 Issued in WI

Practice address

2801 W. Kinnickinnic River Parkway
Suite 370
Milwaukee, WI 53215

Phone

(414) 672-6006

Fax

(414) 672-6016

NPI assigned

Mar 9, 2006

Last updated

May 2, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Urology

Education

University of Wisconsin School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Watertown Physician Practices LLCGroup PAC ID 8022329408, 64 clinicians

Urology Associates LTD SCGroup PAC ID 0143298919, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
• Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116
• Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
• Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.kidd.1@17022.direct.athenahealth.com
• Direct secure messaging: ckidd35502@direct.phci.org

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.

• Urology Associates LTD SC

  • Urology Physician
  • Waukesha, WI
  • NPI 1316035637
  Medicare reassignment Care Compare group NPD
• Watertown Physician Practices LLC

  • Family Medicine Physician
  • Watertown, WI
  • NPI 1770964363
  Medicare reassignment Care Compare group NPD
• Watertown Physician Practices LLC

  • Obstetrics & Gynecology Physician
  • Watertown, WI
  • NPI 1225412265

  Urology

  NPD
• Watertown Physician Practices LLC

  dba WRMC Center for Eye Wear

  • Durable Medical Equipment & Medical Supplies
  • Watertown, WI
  • NPI 1528558749
  NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1003861188
  NPD (past)

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

• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  dba Ascension SE Wisconsin Hospital-Elmbrook Campus

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Ascension St Francis Hospital, Inc

  dba Ascension St Francis Hospital

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1225087190
  Care Compare affiliation
• Columbia St. Mary's Hospital Milwaukee, Inc.

  dba Ascension Columbia St Mary's Hospital Milwaukee Campus

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1871656082
  Care Compare affiliation
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation
• Watertown Medical Center LLC

  dba Watertown Regional Medical Center

  • General Acute Care Hospital
  • Watertown, WI
  • NPI 1992776041
  Care Compare affiliation

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1508834193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W. KINNICKINNIC RIVER PARKWAY",
            "address_2": "SUITE 370",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-672-6006",
            "fax_number": "414-672-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W. KINNICKINNIC RIVER PARKWAY",
            "address_2": "SUITE 370",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-672-6006",
            "fax_number": "414-672-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "CHARLES",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "46512020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34472100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "340020435",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen Kickbush
• Jennifer Susan Kickendahl, MD
• Srividya Kidambi, M.D.
• Edom Kidane, MD
• Britney Kidd
• Kidney Institute of Wisconsin, LLC
• Kids College Corporation
• Kids in Balance
• Kids in Transition
• Lorelle Patricia Kiecker, PA

• Urology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Urology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.