Samuel H Idarraga, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

33511-020 Issued in WI

Practice address

2645 N Mayfair Rd
Suite 200
Wauwatosa, WI 53226-1304

Phone

(414) 479-1800

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Medical College of Wisconsin, 1989

Medicare assignment

May accept Medicare assignment

Group practices

Allegiance Internal Medicine Specialists, SCGroup PAC ID 7517156433, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Allegiance Internal Medicine Specialists, SC

  • Internal Medicine Physician
  • Wauwatosa, WI
  • NPI 1699808196
  Medicare reassignment Care Compare group NPD

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

• Ascension SE Wisconsin Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Froedtert Memorial Lutheran Hospital, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1700850070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 N MAYFAIR RD",
            "address_2": "SUITE 200",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261304",
            "telephone_number": "414-479-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 N MAYFAIR RD",
            "address_2": "SUITE 200",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261304",
            "telephone_number": "414-479-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDARRAGA",
        "first_name": "SAMUEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "33511-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William G Hurd, PT
• Jacinda Hurt, APNP
• Melissa Hying, M.S. CCC-SLP
• Hypnos, Inc.
• Icare Health Care Services
• Gerald L Ignace, M.D.
• Ihc-Wheaton Anesthesia LLC
• Ihc-Wheaton Anesthesia LLC
• Ikar J. Kalogjera, M.D., S.C.
• Bradley Thomas Ilk

• Internal Medicine Physician in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.