NPIMap

Organization Active NPI

Oak Medical SC

  • Internal Medicine Physician
  • Waukesha, WI
National Provider Identifier
1669910345
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OAK MEDICAL SC
Practice address
N20W22961 Watertown Rd
Waukesha, WI 53186-1308
Phone
(262) 875-5070
Fax
(866) 384-9486
NPI assigned
Feb 2, 2017
Last updated
Jun 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Mahtab Sidhu, M.D.NPI 1700866365
Title
Medical Director
Phone
(262) 875-5070

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Internal Medicine Physician 207R00000X Primary
Physical Medicine & Rehabilitation Physician 208100000X

Addresses

Primary practice location

N20W22961 Watertown Rd
Waukesha, WI 53186-1308

Mailing address

N20W22961 Watertown Rd
Waukesha, WI 53186-1308
Phone (262) 875-5070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170331001848 WI Part B Supplier - Clinic/Group Practice 0042595175 Receives reassigned benefits from 196 practitioners
Practice locations: Milwaukee, WI; Oconomowoc, WI; Watertown, WI; Waukesha, WI; Menomonee Falls, WI; Brookfield, WI; Elkhorn, WI; Germantown, WI…

National Provider Directory

National Provider Directory

Locations

6308 8th Ave
Ste 1040
Kenosha, WI 53143
Phone (262) 653-5437

3237 S 16th St
Fl 5
Milwaukee, WI 53215
Phone (414) 646-6991

4500 W Loomis Rd
Milwaukee, WI 53220
Phone (414) 325-5300

837 E Veterans Way
Mukwonago, WI 53149
Phone (262) 363-6830

13755 W Fieldpointe Dr
New Berlin, WI 53151
Phone (262) 796-3600

121 Hospital Dr
Watertown, WI 53098
Phone (920) 261-2382

1200 Delafield St
Waukesha, WI 53188

2428 N Grandview Blvd
Waukesha, WI 53188
Phone (262) 875-5070

2428 N Grandview Blvd
Ste 102
Waukesha, WI 53188
Phone (262) 875-5070

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Maplewood CenterWest Allis, WI, CCN 525069 Skilled nursing facility Adp of the SNF Apr 8, 2025
Brown County Community Treatment Center - Bayshore VillageGreen Bay, WI, CCN 525693 Skilled nursing facility Adp of the SNF Oct 29, 2022
Holton ManorElkhorn, WI, CCN 525541 Skilled nursing facility Adp of the SNF Jan 14, 2019
Geneva Lake ManorLake Geneva, WI, CCN 525565 Skilled nursing facility Adp of the SNF Oct 10, 2022
Careview Health and Rehab of MinocquaMinocqua, WI, CCN 525678 Skilled nursing facility Adp of the SNF Dec 14, 2024
Hillsboro Health and Rehab LLCHillsboro, OH, CCN 365994 Skilled nursing facility Adp of the SNF Jun 30, 2025

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 204

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 204

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1669910345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861308",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861308",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK MEDICAL SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "MAHTAB",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "262-875-5070",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.