Individual provider Active NPI

Shekhar A Dagam, M.D.

  • Neurological Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1629020946
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
43514-020 Issued in WI
Practice address
2801 W Kinnickinnic River Parkway
Suite 550
Milwaukee, WI 53215
Phone
(414) 385-7150
Fax
(414) 385-7159
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 43514-020 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Parkway
Suite 550
Milwaukee, WI 53215

Mailing address

2801 W Kinnickinnic River Parkway
Suite 550
Milwaukee, WI 53215
Phone (414) 385-7150

Other identifiers 1

IdentifierTypeStateIssuer
34412200MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050615001009 WI Practitioner - Neurosurgery 4183610587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
27.27 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
65.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43514-020WIMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shekhar a Dagam MD Neurological Surgery SC Neurological Surgery CurrentSince Jun 19, 2003 Accepting new patients
Neurologic Associates of Wisconsin LTD Neurological Surgery PastSince Jul 1, 1999 Accepting new patients
Neurologic Associates of Waukesha, LTD Past Accepting new patients
Neurosurgery and Endovascular Associates SC. Past Accepting new patients

Locations

4600 W Loomis Rd
Ste 101
Milwaukee, WI 53220
Phone (414) 488-1802

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

20700 Watertown Rd
Ste 101
Waukesha, WI 53186
Phone (262) 717-9850

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1629020946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PARKWAY",
            "address_2": "SUITE 550",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-385-7150",
            "fax_number": "414-385-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PARKWAY",
            "address_2": "SUITE 550",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-385-7150",
            "fax_number": "414-385-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGAM",
        "first_name": "SHEKHAR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WI",
            "license": "43514-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34412200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.