Individual provider Active NPI

Peter Wolfgram, M.D.

  • Pediatric Endocrinology Physician
  • Milwaukee, WI
National Provider Identifier
1598968208
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
54249 Issued in WI
Practice address
9000 W Wisconsin Ave
Pediatric Endocrinology
Milwaukee, WI 53226-4874
Phone
(414) 266-6750
Fax
(414) 266-6749
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 54249 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Pediatric Endocrinology
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Pediatric Endocrinology
Milwaukee, WI 53226-4874
Phone (414) 266-6750

Other practice location 1

555 Redbird Cir Ste 200
DE Pere, WI 54115-7979
Phone (920) 338-6820

Other practice location 2

4855 S Moorland Rd
New Berlin, WI 53151-7494
Phone (262) 432-7702

Other identifiers 1

IdentifierTypeStateIssuer
1598968208MedicaidWI

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
I20140204000069 WI Practitioner - EndocrinologyPractitioner - Pediatric Medicine 9133358658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Pediatric Medicine
Education
University of Wisconsin School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Specialty Group IncGroup PAC ID 2567813447, 206 clinicians

Practice addresses (Care Compare)

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54249WIMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Specialty Group, Inc. CurrentSince Nov 29, 2025 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Dec 20, 2013 Accepting new patients

Locations

555 Redbird Cir
Ste 200
De Pere, WI 54115
Phone (920) 338-6820

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

4855 S Moorland Rd
New Berlin, WI 53151
Phone (262) 432-7599

1601 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 459-4767

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

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

Interoperability endpoints

  • Direct secure messaging: pwolfgram23996@direct.chw.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1598968208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC ENDOCRINOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6750",
            "fax_number": "414-266-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC ENDOCRINOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6750",
            "fax_number": "414-266-6749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Redbird Cir Ste 200",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541157979",
            "country_code": "US",
            "telephone_number": "920-338-6820",
            "fax_number": "414-266-6749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4855 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517494",
            "country_code": "US",
            "telephone_number": "262-432-7702",
            "fax_number": "262-432-7795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFGRAM",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "WI",
            "license": "54249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598968208",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.