Active NPI
Michael P Waliszewski, DDS, MSD
- Prosthodontics
- Brookfield, WI
National Provider Identifier
1609913367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 5475
- Practice address
- 19990 W Greenfield Ave
Brookfield, WI 53045-3733 - Phone
- (262) 787-0677
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 5475 | WI | Primary |
Addresses
Primary practice location
19990 W Greenfield Ave
Brookfield, WI 53045-3733
Mailing address
19990 W Greenfield Ave
Brookfield, WI 53045-3733
Phone (262) 787-0677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 27, 2015 through Nov 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5475 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prosthodontic Solutions LLC | 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.
-
- Dental Clinic/Center
- Brookfield, WI
- NPI 1306232376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453420800000",
"number": "1609913367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19990 W GREENFIELD AVE",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530453733",
"telephone_number": "262-787-0677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19990 W GREENFIELD AVE",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530453733",
"telephone_number": "262-787-0677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALISZEWSKI",
"first_name": "MICHAEL",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2016-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "WI",
"license": "5475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.