Pediatric Ear, Nose & Throat Specialists SC

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

22968 Issued in WI

Legal business name

PEDIATRIC EAR, NOSE & THROAT SPECIALISTS SC

Practice address

9000 W Wisconsin Ave
Suite 265
Milwaukee, WI 53226-3518

Phone

(414) 266-2761

Fax

(414) 266-2766

NPI assigned

Feb 16, 2007

Organization subpart

No

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

Authorized official

Name

David J Beste, M.D.

Title

President

Phone

(414) 266-2761

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy John Martin, MD

  • Otolaryngology Physician
  • Milwaukee, WI
  • NPI 1427137132
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338336000000",
    "number": "1528102498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "SUITE 265",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263518",
            "telephone_number": "414-266-2761",
            "fax_number": "414-266-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "SUITE 265",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263518",
            "telephone_number": "414-266-2761",
            "fax_number": "414-266-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC EAR, NOSE & THROAT SPECIALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2012-05-30",
        "status": "A",
        "authorized_official_last_name": "BESTE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-266-2761",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "WI",
            "license": "22968",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "WI",
            "license": "43113",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30581400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34060600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jo Anne Pedersen, MSW
• Jessica Dee Pederson
• Elizabeth Anne Pedi, DPT
• Pediatric and Adult Medicine Associates S.C.
• Pediatric Diagnostic Imaging, S.C.
• Pediatric Oral Surgery and General Dental Inc SC
• Pediatric Radiologic Services SC
• Kathrine E Pedriana, PA
• Pedro N Banda MD SC
• Jacqueline O Peebles, MD

• Pediatric Otolaryngology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatric Otolaryngology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.