Bernard J Staller, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

18507 Issued in WI

Practice address

2801 W Kinnickinnic River Pkwy
Suite 840
Milwaukee, WI 53215-3669

Phone

(414) 649-3530

Fax

(414) 649-3551

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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.

• West Allis Memorial Hospital, Inc.

  • General Acute Care Hospital
  • West Allis, WI
  • NPI 1407801640
  NPD
• Cardiovascular Associates of Wisconsin, LLP

  • Cardiovascular Disease Physician
  • Milwaukee, WI
  • NPI 1841286291
  NPD (past)
• Midwest Area Physicians, LLC

  • Anesthesiology Physician
  • Milwaukee, WI
  • NPI 1245470699

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1700886686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2040",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532012040",
            "telephone_number": "414-649-3530",
            "fax_number": "414-649-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "SUITE 840",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-649-3530",
            "fax_number": "414-649-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLER",
        "first_name": "BERNARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "18507",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "18507-020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30239700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Stafford, FNP-BC
• Samantha Ann Stageman
• Jennifer L Stagg, LCSW
• Catherine Jane Stahl, PT
• Kimberly Ann Stahn, M.S. CCC-SLP
• Dawn Stallworth, LCSW
• Scott E Stamn, PT
• John Olaf Stampen
• Katalin Skelton Stanaszak, MSN, RN, AGCNS-BC
• Thomas Stancato, CAA

• Cardiovascular Disease Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Cardiovascular Disease Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.