NPIMap

Individual provider Active NPI

Atif A Qureshi, MD

  • Nephrology Physician
  • Neenah, WI
National Provider Identifier
1629014790
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
47193 Issued in WI
Practice address
300 N Commercial St
Ste 200
Neenah, WI 54956-2619
Phone
(920) 886-0818
Fax
(920) 886-0773
NPI assigned
Jun 20, 2006
Last updated
Feb 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 47193 WI Primary

Addresses

Primary practice location

300 N Commercial St
Ste 200
Neenah, WI 54956-2619

Mailing address

300 N Commercial St
Ste 200
Neenah, WI 54956-2619
Phone (920) 886-0818

Other identifiers 2

IdentifierTypeStateIssuer
34568100MedicaidWI
21280500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041025000028 WI Practitioner - Nephrology 5597726489 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians
Fox Valley Nephrology Partners S CGroup PAC ID 3870559404, 12 clinicians

Practice addresses (Care Compare)

2005 Midway Rd
Menasha, WI 54952-7002
Phone (920) 832-8500

300 N Commercial St
Suite 200
Neenah, WI 54956-2619
Phone (920) 886-0818

333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 720-2300

4480 W Spencer St
Appleton, WI 54915
Phone (920) 738-4800

600 N Westhaven Dr
Oshkosh, WI 54904-6926
Phone (920) 725-0077

670 Cormier Rd
Green Bay, WI 54304-4824
Phone (920) 494-9685

W5282 Amy Ave
Appleton, WI 54915-7233
Phone (920) 358-1900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47193WIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Feb 1, 2020 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Feb 1, 2020 Accepting new patients
Thedacare, Incorporated CurrentSince Apr 16, 2014 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Feb 1, 2020 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Feb 1, 2020 Accepting new patients
Smithgall Dialysis LLC PastSince Jun 1, 2021 Accepting new patients

Locations

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

670 Cormier Rd
Green Bay, WI 54304
Phone (920) 494-9685

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: aqureshi844@direct.thedacare.org

Organizations & group practices 8

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.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1629014790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N COMMERCIAL ST",
            "address_2": "STE 200",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562619",
            "telephone_number": "920-886-0818",
            "fax_number": "920-886-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N COMMERCIAL ST",
            "address_2": "STE 200",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562619",
            "telephone_number": "920-886-0818",
            "fax_number": "920-886-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "ATIF",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "47193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34568100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21280500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.