Individual provider Active NPI

Socrates Kaitson, DO

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1558924423
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101025708 Issued in MI
Practice address
5000 W Chambers St
Milwaukee, WI 53210
Phone
(414) 447-2000
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Emergency Medicine Physician 207P00000X 5101025708 MI Primary

Addresses

Primary practice location

5000 W Chambers St
Milwaukee, WI 53210

Mailing address

10625 W North Ave Ste 101B
Wauwatosa, WI 53226-2315

Other practice location 1

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5392

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
I20220714001828 WI Practitioner - Emergency Medicine 2769718154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4011

3807 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-8173

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
EMS Observation, S.C. Emergency Medicine CurrentSince Jul 10, 2022 Accepting new patients

Locations

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

10625 W North Ave
Ste 101B
Wauwatosa, WI 53226
Phone (414) 727-9183

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1558924423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 101B",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W CHAMBERS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53210",
            "telephone_number": "414-447-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N Perry St",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483422217",
            "country_code": "US",
            "telephone_number": "248-338-5392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAITSON",
        "first_name": "SOCRATES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101025708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.