Individual provider Active NPI

Pedro O Ranola, MD

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1629167887
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21444 Issued in WI
Practice address
1919 W North Ave
#200
Milwaukee, WI 53205-1153
Phone
(414) 287-1000
Fax
(414) 287-1010
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21444 WI Primary

Addresses

Primary practice location

1919 W North Ave
#200
Milwaukee, WI 53205-1153

Mailing address

4555 W Schroeder Dr
#170
Milwaukee, WI 53223-1475
Phone (414) 365-3210

Other identifiers 1

IdentifierTypeStateIssuer
30170400MedicaidWI

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

LicenseStateTypeSpecialty
21444WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Genetics Institute, S.C. PastSince Sep 1, 2004 Accepting new patients
Luma Healthcare, Inc Family Medicine PastSince Apr 1, 2013 Accepting new patients

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1629167887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 W SCHROEDER DR",
            "address_2": "#170",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532231475",
            "telephone_number": "414-365-3210",
            "fax_number": "414-365-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 W NORTH AVE",
            "address_2": "#200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051153",
            "telephone_number": "414-287-1000",
            "fax_number": "414-287-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANOLA",
        "first_name": "PEDRO",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "21444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30170400",
            "state": "WI"
        }
    ],
    "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 11, 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.

Verify at the official NPI Registry.