Individual provider Active NPI

J Channing Tassone, MD

  • Orthopaedic Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1629022546
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
39164 Issued in WI
Practice address
9000 W Wisconsin Ave
Pediatric Orthopaedic Surgery
Milwaukee, WI 53226-4874
Phone
(414) 337-7320
Fax
(414) 337-7337
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X 39164 WI
Orthopaedic Surgery Physician 207X00000X 39164 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Pediatric Orthopaedic Surgery
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Pediatric Orthopaedic Surgery
Milwaukee, WI 53226-4874
Phone (414) 337-7320

Other practice location 1

3195 Hillside Dr
Delafield, WI 53018-2189
Phone (262) 646-9950

Other practice location 2

3365 S 103rd St
Milwaukee, WI 53227-4161
Phone (414) 607-5280

Other practice location 3

2575 E Evergreen Dr
Appleton, WI 54913-8910
Phone (920) 969-5353

Other practice location 4

4855 S Moorland Rd
New Berlin, WI 53151-7494
Phone (414) 607-5280

Other practice location 5

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-7400

Other identifiers 2

IdentifierTypeStateIssuer
004000261TOtherHUMANA
1629022546MedicaidWI

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
I20040717000272 WI Practitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 0244219707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Pediatric Medicine
Education
University of Washington School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Specialty Group IncGroup PAC ID 2567813447, 206 clinicians

Practice addresses (Care Compare)

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39164WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Mar 15, 2010 Accepting new patients
Children'S Specialty Group, Inc. CurrentSince Jun 28, 2024 Accepting new patients

Locations

2575 E Evergreen Dr
Appleton, WI 54913
Phone (920) 969-5353

3195 Hillside Dr
Delafield, WI 53018
Phone (262) 646-9950

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

3365 S 103rd St
Milwaukee, WI 53227
Phone (414) 321-3951

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

4855 S Moorland Rd
New Berlin, WI 53151
Phone (262) 432-7599

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • Direct secure messaging: ctassone5761@direct.chw.org

Organizations & group practices 2

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1629022546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC ORTHOPAEDIC SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-337-7320",
            "fax_number": "414-337-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC ORTHOPAEDIC SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-337-7320",
            "fax_number": "414-337-7337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3195 Hillside Dr",
            "address_purpose": "LOCATION",
            "city": "Delafield",
            "state": "WI",
            "postal_code": "530182189",
            "country_code": "US",
            "telephone_number": "262-646-9950",
            "fax_number": "414-266-6870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3365 S 103rd St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532274161",
            "country_code": "US",
            "telephone_number": "414-607-5280",
            "fax_number": "414-607-5288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2575 E Evergreen Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549138910",
            "country_code": "US",
            "telephone_number": "920-969-5353",
            "fax_number": "414-337-7201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4855 S Moorland Rd",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531517494",
            "country_code": "US",
            "telephone_number": "414-607-5280",
            "fax_number": "414-607-5288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-7400",
            "fax_number": "414-805-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TASSONE",
        "first_name": "J",
        "middle_name": "CHANNING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "WI",
            "license": "39164",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "39164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "004000261T",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629022546",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.