Individual provider Active NPI

Vahag Vartanian, M.D.

  • Psychiatry Physician
  • Racine, WI
National Provider Identifier
1578525580
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
62181 Issued in WI
Practice address
1320 Wisconsin Ave
Racine, WI 53403-1978
Phone
(262) 687-2222
Fax
(262) 687-2495
NPI assigned
Apr 5, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 62181 WI Primary

Addresses

Primary practice location

1320 Wisconsin Ave
Racine, WI 53403-1978

Mailing address

1320 Wisconsin Ave
Racine, WI 53403-1978
Phone (262) 687-2222

Other identifiers 1

IdentifierTypeStateIssuer
1578525580MedicaidWI

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
I20140515002076 WI Practitioner - Psychiatry 8921221169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Uniformed Services Uhs Fe Hebert School of Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3237 S 16TH St
Milwaukee, WI 53215-4526
Phone (414) 647-5069

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62181WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension St Francis Hospital, Inc CurrentSince Jun 1, 2014 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jun 1, 2014 Accepting new patients
Ascension St Francis Hospital, Inc CurrentSince Jun 1, 2014 Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3237 S 16th St
Milwaukee, WI 53215
Phone (414) 647-5000

3267 S 16th St
Ste 200
Milwaukee, WI 53215
Phone (414) 389-3111

1320 Wisconsin Ave
Racine, WI 53403
Phone (262) 687-2222

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578525580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031978",
            "telephone_number": "262-687-2222",
            "fax_number": "262-687-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031978",
            "telephone_number": "262-687-2222",
            "fax_number": "262-687-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARTANIAN",
        "first_name": "VAHAG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "62181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578525580",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.