NPIMap

Organization Active NPI

Froedtert &the Medical College of Wisconsin Community Physicians Inc

  • Durable Medical Equipment & Medical Supplies
  • Oak Creek, WI
National Provider Identifier
1649700980
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC
Practice address
7901 South 6TH Street
Oak Creek, WI 53154
Phone
(414) 346-8000
NPI assigned
Jun 19, 2017
Last updated
Jul 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Amir Abbas Ghaferi, MD
Title
President & Ceo
Phone
(734) 660-4939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

7901 South 6TH Street
Oak Creek, WI 53154

Mailing address

N74W12501 Leatherwood CT
Menomonee Falls, WI 53051-4490
Phone (414) 777-0417

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180306000584 WI DME Supplier - Physician - General PracticeDME Supplier - Multi-Specialty - Physician 3678760063 Practice locations: Oak Creek, WI

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Froedtert Med Coll Wi Comm19 organizations share this tax ID, including this one
Part of
Froedtert Med Coll Wi Comm

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1649700980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N74W12501 LEATHERWOOD CT",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514490",
            "telephone_number": "414-777-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 SOUTH 6TH STREET",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "53154",
            "telephone_number": "414-346-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC",
        "enumeration_date": "2017-06-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "GHAFERI",
        "authorized_official_first_name": "AMIR",
        "authorized_official_middle_name": "ABBAS",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "734-660-4939",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.