Active NPI
Wellifycare Medical S.C.
- Internal Medicine Physician
- Brookfield, WI
National Provider Identifier
1629914155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- WELLIFYCARE MEDICAL S.C.
- Practice address
- 18200 W Capitol Dr Ste 200
Brookfield, WI 53045-1446 - Phone
- (262) 261-8880
- NPI assigned
- Apr 27, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dereje Tefera Siyum, MD
- Title
- President
- Phone
- (262) 261-8880
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetology (Internal Medicine) Physician | 207QB0505X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Obesity Medicine (Internal Medicine) Physician | 207RB0002X | |||
| Hypertension Specialist Physician | 207RH0005X | |||
| Physician Nutrition Specialist (Internal Medicine) | 207RP1002X | |||
| Obesity Medicine (Preventive Medicine) Physician | 2083B0002X | |||
| Clinical Informatics Physician | 2083C0008X | |||
| Hospitalist Physician | 208M00000X |
Addresses
Primary practice location
18200 W Capitol Dr Ste 200
Brookfield, WI 53045-1446
Mailing address
W193N4932 Tea Tree Dr
Menomonee Falls, WI 53051-1644
Phone (262) 261-8880
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777248000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785801600000",
"number": "1629914155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W193N4932 TEA TREE DR",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530511644",
"telephone_number": "262-261-8880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18200 W CAPITOL DR STE 200",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530451446",
"telephone_number": "262-261-8880"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLIFYCARE MEDICAL S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2026-04-27",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A",
"authorized_official_last_name": "SIYUM",
"authorized_official_first_name": "DEREJE",
"authorized_official_middle_name": "TEFERA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "262-261-8880",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207QB0505X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Diabetology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RB0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Obesity Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RH0005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hypertension Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RP1002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Physician Nutrition Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2083B0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Preventive Medicine, Obesity Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2083C0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Preventive Medicine, Clinical Informatics",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.