NPIMap

Organization Active NPI

Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
National Provider Identifier
1568787448
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS, INC.
Practice address
W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002
Phone
(262) 255-2500
NPI assigned
Apr 2, 2010
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
FROEDTERT HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Authorized official

Name
Amir Abbas Ghaferi, MD
Title
President & Ceo
Phone
(734) 660-4939

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Multi-Specialty Clinic/Center 261QM1300X
Urgent Care Clinic/Center 261QU0200X
Clinical Medical Laboratory 291U00000X 52D0678401 WI
Clinical Medical Laboratory 291U00000X 52D2096793 WI
Clinical Medical Laboratory 291U00000X 52D0388485 WI
Clinical Medical Laboratory 291U00000X 52D2066480 WI
Durable Medical Equipment & Medical Supplies 332B00000X
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002

Mailing address

N74W12501 Leatherwood CT
Menomonee Falls, WI 53051-4490

Other practice location 1

N69W5269 Columbia Rd
Cedarburg, WI 53012-2103
Phone (262) 474-8600

Other practice location 2

4931 S 27th St
Greenfield, WI 53221-2652
Phone (414) 281-9533

Other practice location 3

11211 W Lincoln Ave
West Allis, WI 53227-1035
Phone (414) 454-8300

Other practice location 4

1271 N 6th St
Milwaukee, WI 53212-3360
Phone (414) 978-9100

Other practice location 5

N51W24953 Lisbon Rd
Pewaukee, WI 53072-1403
Phone (262) 532-8691

Other practice location 6

1701 Fond Du Lac Ave
Kewaskum, WI 53040-9129
Phone (262) 626-4616

Other practice location 7

601 N 99th St
Wauwatosa, WI 53226-4339
Phone (414) 454-7850

Other practice location 8

1316 W Forest Home Ave Ste A
Milwaukee, WI 53204-3227
Phone (414) 424-5000

Other practice location 9

7208 N 76th St
Milwaukee, WI 53223-4502
Phone (414) 454-4800

Other practice location 10

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

Other practice location 11

2180 S Main St
West Bend, WI 53095-5754
Phone (262) 532-3127

Other practice location 12

W225N16711 Cedar Park Ct
Jackson, WI 53037-9222
Phone (262) 677-1101

Other practice location 13

W180N8085 Town Hall Rd Fl 3
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

Other practice location 14

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

Other practice location 15

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone (262) 253-5400

Other practice location 16

11430 N Port Washington Rd
Mequon, WI 53092-3414
Phone (262) 518-1900

Other practice location 17

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051-2301
Phone (262) 532-1100

Other practice location 18

16650 W Bluemound Rd Ste 200
Brookfield, WI 53005-5959
Phone (262) 827-9200

Other practice location 19

1905 N Calhoun Rd
Brookfield, WI 53005-5005
Phone (262) 754-8000

Other practice location 20

6220 W Loomis Rd
Greendale, WI 53129-2448
Phone (414) 423-0555

Other practice location 21

110 Lone Oak Ln
Hartford, WI 53027-2600
Phone (262) 670-1800

Other practice location 22

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7200

Other practice location 23

2315 E Moreland Blvd
Waukesha, WI 53186-2939
Phone (262) 532-5700

Other practice location 24

1901 E Capitol Dr
Shorewood, WI 53211-2335
Phone (414) 424-5300

Other practice location 25

1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451

Other practice location 26

2071 N Summit Ave
Milwaukee, WI 53202-1320
Phone (414) 615-9400

Other practice location 27

4455 S 108th St
Greenfield, WI 53228-2504
Phone (414) 427-5310

Other practice location 28

11065 N Port Washington Rd
Mequon, WI 53092-5052
Phone (262) 643-1680

Other practice location 29

N109W17110 Ava Cir
Germantown, WI 53022-5642
Phone (262) 798-1224

Other practice location 30

5800 W Layton Ave
Greenfield, WI 53220-4021
Phone (262) 532-3067

Other practice location 31

7901 S 6th St
Oak Creek, WI 53154-2010
Phone (414) 346-8000

Other practice location 32

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (262) 255-2500

Other practice location 33

101 Walnut Cir
Grafton, WI 53024-2452
Phone (262) 240-0872

Other practice location 34

840 N 87th St
Milwaukee, WI 53226-3586
Phone (414) 805-5540

Other practice location 35

6255 N Santa Monica Blvd
Milwaukee, WI 53217-4353
Phone (414) 967-8350

Other practice location 36

W234S3555 Les Paul Pkwy
Waukesha, WI 53189-8512
Phone (262) 532-5820

Other practice location 37

21700 Intertech Dr
Brookfield, WI 53045-5197
Phone (262) 532-8300

Other practice location 38

1350 S Sunny Slope Rd
Brookfield, WI 53005-7060
Phone (262) 798-8750

Other practice location 39

3400 Market Ln
Kenosha, WI 53144-3430
Phone (262) 612-2350

Other practice location 40

N64W25037 Prospect Cir
Sussex, WI 53089-2680
Phone (262) 532-8680

Other practice location 41

1155 N Mayfair Rd
Wauwatosa, WI 53226-3462
Phone (414) 955-5990

Other practice location 42

115 N Sweetwater Blvd
Port Washington, WI 53074-2657
Phone (920) 476-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20101210000699 WI Part B Supplier - Clinic/Group Practice 3678760063 Receives reassigned benefits from 2,487 practitioners
1 other NPI on this enrollment
Practice locations: Port Washington, WI; Mequon, WI; Pewaukee, WI; Oak Creek, WI; New Berlin, WI; Milwaukee, WI; Sussex, WI; Shorewood, WI…
O20110829000170 WI DME Supplier - Multi-Specialty - Physician 3678760063 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Menomonee Falls, WI
O20151125001222 WI Part B Supplier - Independent Clinical Laboratory 3678760063 Practice locations: Milwaukee, WI; Mequon, WI; Menomonee Falls, WI; Kewaskum, WI; Kenosha, WI; Jackson, WI; Hartford, WI; Greenfield, WI…

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Froedtert and the Medical College of Wisconsin Community Physicians

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations (25 of 39)

4201 Saint Antoine St
Ste 5R24
Detroit, MI 48201

1350 S Sunny Slope Rd
Brookfield, WI 53005
Phone (262) 798-8750

13500 W Capitol Dr
Brookfield, WI 53005

21140 W Capitol Dr
Brookfield, WI 53072

6601 Northway
Ste D
Greendale, WI 53129

4455 S 108th St
Ste 160
Greenfield, WI 53228
Phone (414) 427-5310

4455 S 108th St
Ste 180
Greenfield, WI 53228
Phone (414) 955-7199

W126N7338 Flint Dr
Ste 200
Menomonee Falls, WI 53051

W126N7338 Flint Dr
Ste 300
Menomonee Falls, WI 53051

W129N7055 Northfield Dr
Ste 101
Menomonee Falls, WI 53051
Phone (262) 253-5055

W129N7055 Northfield Dr
Ste A100
Menomonee Falls, WI 53051

W129N7055 Northfield Dr
Ste A203
Menomonee Falls, WI 53051

W180N8085 Town Hall Rd
Fl 3
Menomonee Falls, WI 53051

N91W17271 Appleton Ave
Menomonee Fls, WI 53051
Phone (262) 502-3300

11402 N Port Washington Rd
Mequon, WI 53092
Phone (262) 306-6319

110 Lone Oak Ln
Milwaukee, WI 53278

1316 W Forest Home Ave
Milwaukee, WI 53204
Phone (414) 424-5000

1316 W Forest Home Ave
Ste A
Milwaukee, WI 53204
Phone (414) 424-5000

2071 N Summit Ave
Milwaukee, WI 53202
Phone (414) 615-9400

2350 N Lake Dr
Ste 400
Milwaukee, WI 53211
Phone (414) 271-1633

6255 W N Ave
Milwaukee, WI 53213

1230 Corporate Center Dr
Ste 400
Oconomowoc, WI 53066
Phone (262) 560-1527

209 Pewaukee Rd
Pewaukee, WI 53072
Phone (262) 956-6150

2631 Eastern Ave
Plymouth, WI 53073
Phone (920) 320-2436

115 N Sweetwater Blvd
Port Washington, WI 53074
Phone (920) 476-6300

Practitioners & affiliated clinicians

Practitioners 2,631

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 2,631

NPI Registry JSON

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

{
    "created_epoch": "1270166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1568787448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N74W12501 LEATHERWOOD CT",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W180N8000 TOWN HALL RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514002",
            "telephone_number": "262-255-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N69W5269 Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Cedarburg",
            "state": "WI",
            "postal_code": "530122103",
            "country_code": "US",
            "telephone_number": "262-474-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4931 S 27th St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532212652",
            "country_code": "US",
            "telephone_number": "414-281-9533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11211 W Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "West Allis",
            "state": "WI",
            "postal_code": "532271035",
            "country_code": "US",
            "telephone_number": "414-454-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1271 N 6th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532123360",
            "country_code": "US",
            "telephone_number": "414-978-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N51W24953 Lisbon Rd",
            "address_purpose": "LOCATION",
            "city": "Pewaukee",
            "state": "WI",
            "postal_code": "530721403",
            "country_code": "US",
            "telephone_number": "262-532-8691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Fond Du Lac Ave",
            "address_purpose": "LOCATION",
            "city": "Kewaskum",
            "state": "WI",
            "postal_code": "530409129",
            "country_code": "US",
            "telephone_number": "262-626-4616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 N 99th St",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532264339",
            "country_code": "US",
            "telephone_number": "414-454-7850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1316 W Forest Home Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532043227",
            "country_code": "US",
            "telephone_number": "414-424-5000",
            "fax_number": "262-725-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7208 N 76th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532234502",
            "country_code": "US",
            "telephone_number": "414-454-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W168N11237 Western Ave",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "WI",
            "postal_code": "530223239",
            "country_code": "US",
            "telephone_number": "262-253-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2180 S Main St",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530955754",
            "country_code": "US",
            "telephone_number": "262-532-3127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W225N16711 Cedar Park Ct",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "WI",
            "postal_code": "530379222",
            "country_code": "US",
            "telephone_number": "262-677-1101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W180N8085 Town Hall Rd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-251-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530959274",
            "country_code": "US",
            "telephone_number": "262-836-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W129N7055 Northfield Dr",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530510538",
            "country_code": "US",
            "telephone_number": "262-253-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11430 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923414",
            "country_code": "US",
            "telephone_number": "262-518-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N91W15750 Falls Pkwy",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530512301",
            "country_code": "US",
            "telephone_number": "262-532-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16650 W Bluemound Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055959",
            "country_code": "US",
            "telephone_number": "262-827-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1905 N Calhoun Rd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055005",
            "country_code": "US",
            "telephone_number": "262-754-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6220 W Loomis Rd",
            "address_purpose": "LOCATION",
            "city": "Greendale",
            "state": "WI",
            "postal_code": "531292448",
            "country_code": "US",
            "telephone_number": "414-423-0555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Lone Oak Ln",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "WI",
            "postal_code": "530272600",
            "country_code": "US",
            "telephone_number": "262-670-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4805 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517401",
            "country_code": "US",
            "telephone_number": "262-798-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 E Moreland Blvd",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531862939",
            "country_code": "US",
            "telephone_number": "262-532-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Shorewood",
            "state": "WI",
            "postal_code": "532112335",
            "country_code": "US",
            "telephone_number": "414-424-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 W Paradise Dr",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530959795",
            "country_code": "US",
            "telephone_number": "262-334-3451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2071 N Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532021320",
            "country_code": "US",
            "telephone_number": "414-615-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4455 S 108th St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532282504",
            "country_code": "US",
            "telephone_number": "414-427-5310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11065 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530925052",
            "country_code": "US",
            "telephone_number": "262-643-1680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N109W17110 Ava Cir",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "WI",
            "postal_code": "530225642",
            "country_code": "US",
            "telephone_number": "262-798-1224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5800 W Layton Ave",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532204021",
            "country_code": "US",
            "telephone_number": "262-532-3067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531542010",
            "country_code": "US",
            "telephone_number": "414-346-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "262-255-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Walnut Cir",
            "address_purpose": "LOCATION",
            "city": "Grafton",
            "state": "WI",
            "postal_code": "530242452",
            "country_code": "US",
            "telephone_number": "262-240-0872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 N 87th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263586",
            "country_code": "US",
            "telephone_number": "414-805-5540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6255 N Santa Monica Blvd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532174353",
            "country_code": "US",
            "telephone_number": "414-967-8350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W234S3555 Les Paul Pkwy",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531898512",
            "country_code": "US",
            "telephone_number": "262-532-5820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21700 Intertech Dr",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530455197",
            "country_code": "US",
            "telephone_number": "262-532-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Sunny Slope Rd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530057060",
            "country_code": "US",
            "telephone_number": "262-798-8750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Market Ln",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531443430",
            "country_code": "US",
            "telephone_number": "262-612-2350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N64W25037 Prospect Cir",
            "address_purpose": "LOCATION",
            "city": "Sussex",
            "state": "WI",
            "postal_code": "530892680",
            "country_code": "US",
            "telephone_number": "262-532-8680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 N Mayfair Rd",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532263462",
            "country_code": "US",
            "telephone_number": "414-955-5990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 N Sweetwater Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Washington",
            "state": "WI",
            "postal_code": "530742657",
            "country_code": "US",
            "telephone_number": "920-476-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FROEDTERT HEALTH, INC.",
        "enumeration_date": "2010-04-02",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "GHAFERI",
        "authorized_official_first_name": "AMIR",
        "authorized_official_middle_name": "ABBAS",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "734-660-4939",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D0678401",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D2096793",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D0388485",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D2066480",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.