Individual provider Active NPI

Marvin Edward Lauwasser, MD

  • Infectious Disease Physician
  • Milwaukee, WI
National Provider Identifier
1609823806
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
18393-020 Issued in WI
Practice address
3070 N 51St St
Suite 402
Milwaukee, WI 53210-1645
Phone
(414) 463-4259
Fax
(414) 463-2728
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 18393-020 WI Primary

Addresses

Primary practice location

3070 N 51St St
Suite 402
Milwaukee, WI 53210-1645

Mailing address

3070 N 51St St
Suite 402
Milwaukee, WI 53210-1645
Phone (414) 463-4259

Other identifiers 1

IdentifierTypeStateIssuer
30172000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18393-020WIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emad Botros, M.D., S.C. Past Accepting new patients

Organizations & group practices 1

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1609823806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N 51ST ST",
            "address_2": "SUITE 402",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101645",
            "telephone_number": "414-463-4259",
            "fax_number": "414-463-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N 51ST ST",
            "address_2": "SUITE 402",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101645",
            "telephone_number": "414-463-4259",
            "fax_number": "414-463-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUWASSER",
        "first_name": "MARVIN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WI",
            "license": "18393-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30172000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.