Active NPI
Ali A Diba, M.D.
- Gastroenterology Physician
- Milwaukee, WI
National Provider Identifier
1528029899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 20383-020
- Practice address
- 3201 S 16TH St
2015
Milwaukee, WI 53215-4537 - Phone
- (414) 908-6500
- Fax
- (414) 385-2980
- NPI assigned
- Mar 28, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 20383-020 | WI | Primary |
Addresses
Primary practice location
3201 S 16TH St
2015
Milwaukee, WI 53215-4537
Mailing address
3033 S 27TH St
Suite 202
Milwaukee, WI 53215-3600
Phone (414) 908-6601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30902300 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20383-020 | WI | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528029899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3033 S 27TH ST",
"address_2": "SUITE 202",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153600",
"telephone_number": "414-908-6601",
"fax_number": "414-385-2980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 S 16TH ST",
"address_2": "2015",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532154537",
"telephone_number": "414-908-6500",
"fax_number": "414-385-2980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBA",
"first_name": "ALI",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "WI",
"license": "20383-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30902300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.