Active NPI
Arthur Crisostomo, M.D.
- Pulmonary Disease Physician
- Sussex, WI
National Provider Identifier
1609849140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 28637
- Practice address
- N57W24950 N Corporate Cir
Prohealth Care Medical Associates Inc.
Sussex, WI 53089-4383 - Phone
- (262) 820-3093
- Fax
- (262) 532-9598
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 28637 | WI | Primary |
Addresses
Primary practice location
N57W24950 N Corporate Cir
Prohealth Care Medical Associates Inc.
Sussex, WI 53089-4383
Mailing address
N57W42950 N Corporate Circle
Prohealth Care Medical Associates Inc.
Sussex, WI 53089-4383
Phone (262) 820-3093
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30844600 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28637 | WI | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1609849140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N57W42950 N CORPORATE CIRCLE",
"address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
"city": "SUSSEX",
"state": "WI",
"postal_code": "530894383",
"telephone_number": "262-820-3093",
"fax_number": "262-532-9598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N57W24950 N CORPORATE CIR",
"address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
"city": "SUSSEX",
"state": "WI",
"postal_code": "530894383",
"telephone_number": "262-820-3093",
"fax_number": "262-532-9598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISOSTOMO",
"first_name": "ARTHUR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "WI",
"license": "28637",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30844600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sussex, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.