Organization Active NPI

Wellifycare Medical S.C.

  • Internal Medicine Physician
  • Brookfield, WI
National Provider Identifier
1629914155
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Dr. Dereje Tefera Siyum, MDNPI 1164981007
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)CodeLicenseStatePrimary
Diabetology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QB0505X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Obesity Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RB0002X
Hypertension Specialist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0005X
Physician Nutrition Specialist (Internal Medicine)Group: 193200000X MULTI-SPECIALTY GROUP 207RP1002X
Obesity Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083B0002X
Clinical Informatics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083C0008X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Practitioners & 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.

Verify at the official NPI Registry.