Individual provider Active NPI

Iftekhar Bader, M.D.

  • Pulmonary Disease Physician
  • Racine, WI
National Provider Identifier
1508896671
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
32076 Issued in WI
Practice address
3803 Spring St
Ste 600
Racine, WI 53405-1660
Phone
(262) 687-8312
Fax
(262) 687-8318
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Sleep Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc. 3,764 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

Hospital & facility affiliations

  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Aurora Memorial Hospital Burlington Hospital, Burlington, WI, CCN 520059
  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096

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
I20070319000552 WI Practitioner - Pulmonary DiseasePractitioner - Sleep Medicine 2567565179 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32076WIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Wheaton Franciscan Medical Group Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

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

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 32076 WI
Pulmonary Disease Physician 207RP1001X 32076 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

3803 Spring St
Ste 600
Racine, WI 53405-1660

Mailing address

3803 Spring St
Ste 600
Racine, WI 53405-1660
Phone (262) 687-8312

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
132568000MedicaidWI

Electronic endpoints 2

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address ibader94687@direct.aurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 12, 2022.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1508896671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 SPRING ST",
            "address_2": "STE 600",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051660",
            "telephone_number": "262-687-8312",
            "fax_number": "262-687-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 SPRING ST",
            "address_2": "STE 600",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051660",
            "telephone_number": "262-687-8312",
            "fax_number": "262-687-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "IFTEKHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WI",
            "license": "32076",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "32076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132568000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ibader94687@direct.aurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3803 Spring St",
            "address_2": "Ste 600",
            "city": "Racine",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534051660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3803 Spring St",
            "address_2": "Ste 600",
            "city": "Racine",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534051660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.