Wisconsin Michigan Physicians, SC
Organization Active NPI Interventional Pain Medicine Physician · Niagara, WI
NPI 1699719476 · NPPES record last updated Oct 2, 2018
Key facts
- NPI
- 1699719476
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Interventional Pain Medicine Physician 208VP0014X
- License
- 34886 (WI)
- Legal business name
- WISCONSIN MICHIGAN PHYSICIANS, SC
- Practice address
- 1601 Roosevelt Rd
Niagara, WI 54151-1043 - Phone
- (715) 225-1780
- Fax
- (715) 251-1787
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Francoise Singh, MD
- Title
- Chief Operating Officer
- Phone
- (888) 724-6377
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Subparts reporting this organization as parent 1
Practitioners 5
-
Chandur Piryani, MD
-
Vijay Singh, MD
-
Kayvan D Haddadan, M.D.
-
Nicholas Stuart Raboin, D.C.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0977595 | Wisconsin Michigan Physicians | Certificate of waiver | Aug 29, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MI, WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040203001050 | MI | Part B Supplier - Clinic/Group Practice | 9931092053 |
Receives reassigned benefits from 2 practitioners Practice locations: Escanaba, MI |
| O20040216000583 | WI | Part B Supplier - Clinic/Group Practice | 9931092053 |
Receives reassigned benefits from 3 practitioners Practice locations: Mequon, WI; Niagara, WI |
| O20161219001075 | WI | DME Supplier - Physician - Interventional Pain Management | 9931092053 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mequon, WI |
National Provider Directory
Locations
229 W Genesee St
Iron River, MI 49935
Phone (906) 265-2165
5261 N Port Washington Rd
Glendale, WI 53217
Phone (414) 332-6001
10945 N Port Washington Rd
Ste 101
Mequon, WI 53092
Phone (262) 241-8790
1601 Roosevelt Rd
#6736
Niagara, WI 54151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician |
208VP0014X | 34886 | WI | Yes |
| Durable Medical Equipment & Medical Supplies | 332B00000X | 746200001 | WI |
Addresses
Primary practice location
1601 Roosevelt Rd
Niagara, WI 54151-1043
Mailing address
1601 Roosevelt Rd
PO Box 6
Niagara, WI 54151-1043
Phone (715) 251-1780
Other practice location 1
10945 N Port Washington Rd
Mequon, WI 53092-5078
Phone (262) 478-0301
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CD6737 | Other | MI | RAILROAD MEDICARE |
| CD6736 | Other | WI | RAILROAD MEDICARE |
| 050B210120 | Other | MI | BCBS |
| 21329700 | Medicaid | WI | |
| 110B210270 | Other | MI | BCBS |
Other providers in Niagara, WI
All providers in Niagara, WI · Interventional Pain Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.