Individual provider Active NPI

Travis Kuemmet

  • Dermatology Physician
  • Wauwatosa, WI
National Provider Identifier
1588027023
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
69734 Issued in WI
Practice address
10000 W Bluemound Rd
Wauwatosa, WI 53226-4321
Phone
(414) 454-8000
Fax
(414) 805-3808
NPI assigned
Apr 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 69734 WI Primary

Addresses

Primary practice location

10000 W Bluemound Rd
Wauwatosa, WI 53226-4321

Mailing address

10000 W Bluemound Rd
Wauwatosa, WI 53226-4321
Phone (414) 454-8000

Other practice location 1

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-5320

Other practice location 2

8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 955-8296

Other practice location 3

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

Other practice location 4

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

Other identifiers 1

IdentifierTypeStateIssuer
1588027023MedicaidWI

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
I20200828001905 WI Practitioner - Dermatology 6406195726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

1155 N Mayfair Rd
FL 2
Milwaukee, WI 53226-3462
Phone (414) 955-4263

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions27
Removal or shaving of skin growth1-10
Skin biopsy11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince May 13, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince May 13, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. Dermatology CurrentSince Aug 1, 2020 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

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

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

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

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

10000 W Innovation Dr
Wauwatosa, WI 53226

10000 W Bluemound Rd
Wauwatosa, WI 53226
Phone (414) 456-3000

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

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • Direct secure messaging: tkuemmetmd199343@direct.froedtert.com

Organizations & group practices 4

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1588027023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W BLUEMOUND RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264321",
            "telephone_number": "414-454-8000",
            "fax_number": "414-805-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W BLUEMOUND RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264321",
            "telephone_number": "414-454-8000",
            "fax_number": "414-805-3808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-5320",
            "fax_number": "414-805-5323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 W Watertown Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263548",
            "country_code": "US",
            "telephone_number": "414-955-8296",
            "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",
            "fax_number": "262-798-7271",
            "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",
            "fax_number": "414-346-8010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUEMMET",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "69734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588027023",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.