Active NPI
Santosh N Krishnan, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Milwaukee, WI
National Provider Identifier
1629020391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 47167
- Practice address
- 2801 W Kinnickinnic River Pkwy
#525
Milwaukee, WI 53215-3669 - Phone
- (414) 649-3920
- NPI assigned
- May 17, 2006
- Last updated
- Oct 31, 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 |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 47167 | WI | Primary |
Addresses
Primary practice location
2801 W Kinnickinnic River Pkwy
#525
Milwaukee, WI 53215-3669
Mailing address
2801 W Kinnickinnic River Pkwy
#525
Milwaukee, WI 53215-3669
Phone (414) 649-3920
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34563600 | Medicaid | WI | |
| P00323107 | Other | RR MEDICARE |
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 |
|---|---|---|---|
| 47167 | WI | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Suburban Cardiothoracic Surgery SC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Waukesha, WI
- NPI 1770524191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1629020391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 W KINNICKINNIC RIVER PKWY",
"address_2": "#525",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153669",
"telephone_number": "414-649-3920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 W KINNICKINNIC RIVER PKWY",
"address_2": "#525",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153669",
"telephone_number": "414-649-3920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRISHNAN",
"first_name": "SANTOSH",
"middle_name": "N",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "WI",
"license": "47167",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34563600",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00323107",
"state": null
}
],
"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 Oct 31, 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.