Individual provider Active NPI

Sridhar Rao, M.D., PH.D.

  • Pediatric Hematology & Oncology Physician
  • Milwaukee, WI
National Provider Identifier
1528039849
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
55842-020 Issued in WI
Practice address
9000 W Wisconsin Ave
Pediatric Hematology/Oncology
Milwaukee, WI 53226-4874
Phone
(414) 266-2420
Fax
(414) 456-6543
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 55842-020 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Pediatric Hematology/Oncology
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Pediatric Hematology/Oncology
Milwaukee, WI 53226-4874
Phone (414) 266-2420

Other identifiers 1

IdentifierTypeStateIssuer
1528039849MedicaidWI

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
I20110921000638 WI Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 0244339570 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55842-020WIMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Aug 13, 2011 Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatric Hematology-Oncology PastSince Oct 22, 2023 Accepting new patients

Locations

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: srao7194@direct.chw.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1528039849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC HEMATOLOGY/ONCOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-2420",
            "fax_number": "414-456-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC HEMATOLOGY/ONCOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-2420",
            "fax_number": "414-456-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "SRIDHAR",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "WI",
            "license": "55842-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528039849",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.