NPIMap

Organization Active NPI

Center for Neurological Disorders, SC

  • Neurology Physician
  • Milwaukee, WI
National Provider Identifier
1649223041
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CENTER FOR NEUROLOGICAL DISORDERS, SC
Practice address
3237 S 16TH St
Milwaukee, WI 53215-4526
Phone
(414) 769-4040
Fax
(414) 769-4041
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Authorized official

Name
Dr. Bhupendra O Khatri, M.D.NPI 1013982594
Title
President
Phone
(414) 769-4040

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X WI Primary

Addresses

Primary practice location

3237 S 16TH St
Milwaukee, WI 53215-4526

Mailing address

3237 S 16TH St
Milwaukee, WI 53215-4526
Phone (414) 769-4040

Other practice location 1

10180 Washington Ave
MT Pleasant, WI 53177-1604
Phone (414) 769-4040

Other practice location 2

10750 W Howard Ave
Greenfield, WI 53228-1321
Phone (414) 460-3195

Other identifiers 1

IdentifierTypeStateIssuer
32792200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040109000487 WI Part B Supplier - Clinic/Group Practice 7214836188 Receives reassigned benefits from 12 practitioners
Practice locations: Greenfield, WI; Milwaukee, WI; Mount Pleasant, WI

National Provider Directory

National Provider Directory

Locations

4225 W Oakwood Park Ct
Franklin, WI 53132
Phone (414) 435-0025

2801 W KK Pkwy
Ste 630
Milwaukee, WI 53215

2801 W KK Pkwy
#S140
Milwaukee, WI 53215
Phone (414) 385-2892

2801 W KK Pkwy
#S630
Milwaukee, WI 53215
Phone (414) 385-1801

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1649223041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 S 16TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154526",
            "telephone_number": "414-769-4040",
            "fax_number": "414-769-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 S 16TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154526",
            "telephone_number": "414-769-4040",
            "fax_number": "414-769-4041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10180 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "WI",
            "postal_code": "531771604",
            "country_code": "US",
            "telephone_number": "414-769-4040",
            "fax_number": "414-769-4041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10750 W Howard Ave",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532281321",
            "country_code": "US",
            "telephone_number": "414-460-3195",
            "fax_number": "414-763-0063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR NEUROLOGICAL DISORDERS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "KHATRI",
        "authorized_official_first_name": "BHUPENDRA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-769-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32792200",
            "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 Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.