Individual provider Active NPI

Syed A Gardezi, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Milwaukee, WI
National Provider Identifier
1689626574
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
46596 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy
Suite No. 245
Milwaukee, WI 53215-3669
Phone
(414) 649-6780
Fax
(474) 649-6030
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 46596 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy
Suite No. 245
Milwaukee, WI 53215-3669

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
34594400MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address sgardezi23208@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701000815 WI Practitioner - EndocrinologyPractitioner - Internal Medicine 9133106727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46596WIMDEndocrinology, Diabetes & Metabolism Physician
002560NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Sep 4, 2018 Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 1, 2008 Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 1, 2008 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Syracuse Community Health Center, Inc. Past Accepting new patients

Locations

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

2501 W Silver Spring Dr
Glendale, WI 53209
Phone (414) 461-8250

3130 Shore Dr
Marinette, WI 54143
Phone (715) 735-7421

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2801 W Kinnickinnic River Pkwy
Ste 680
Milwaukee, WI 53215
Phone (414) 385-1922

2801 W Kinnickinnic River Pkwy
Ste 245
Milwaukee, WI 53215
Phone (414) 649-6421

2801 W Kinnickinnic River Pkwy
Ste 260
Milwaukee, WI 53215
Phone (414) 649-6780

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: sgardezi23208@direct.myadvocateaurora.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1689626574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "SUITE NO. 245",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-649-6780",
            "fax_number": "474-649-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDEZI",
        "first_name": "SYED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "46596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34594400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "Suite no. 245",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgardezi23208@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "Suite no. 245",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.