Active NPI
Giuseppe S Miceli, DPM
- Foot Surgery Podiatrist
- Kenosha, WI
National Provider Identifier
1619943354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 524-025
- Practice address
- 7201 Green Bay Rd
Suite a
Kenosha, WI 53142-3532 - Phone
- (262) 925-6565
- Fax
- (262) 697-4291
- NPI assigned
- Feb 23, 2006
- Last updated
- Jan 4, 2011
- 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 |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 524-025 | WI | Primary |
Addresses
Primary practice location
7201 Green Bay Rd
Suite a
Kenosha, WI 53142-3532
Mailing address
7201-Green Bay Road
Suite a
Kenosha, WI 53142
Phone (262) 925-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43208700 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 524-025 | WI | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group-Southeast Wisconsin Inc | Past | Accepting new patients | |
| Hetzel Care Center Inc | Past | Accepting new patients | |
| Asg Onsite Podiatry of Wi 1 SC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Foot Surgery Podiatrist
- Kenosha, WI
- NPI 1154492668
-
dba Ascension Medical Group
- Internal Medicine Physician
- Glendale, WI
- NPI 1609881077
-
- Podiatrist
- Chicago, IL
- NPI 1982957528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294099200000",
"number": "1619943354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7201-GREEN BAY ROAD",
"address_2": "SUITE A",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53142",
"telephone_number": "262-925-6565",
"fax_number": "262-697-4291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7201 GREEN BAY RD",
"address_2": "SUITE A",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531423532",
"telephone_number": "262-925-6565",
"fax_number": "262-697-4291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICELI",
"first_name": "GIUSEPPE",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2011-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "WI",
"license": "524-025",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43208700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.