Individual provider Active NPI

David H Tennenbaum, M.D.

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1710189121
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125050204 Issued in IL
Practice address
2320 N Lake Drive
Room 3603
Milwaukee, WI 53211-4507
Phone
(414) 270-4932
Fax
(414) 291-5195
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125050204 IL Primary

Addresses

Primary practice location

2320 N Lake Drive
Room 3603
Milwaukee, WI 53211-4507

Mailing address

4425 N Port Washington Road
Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 326-2378

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
I20080815000489 WI Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 3072688662 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300

2301 N Lake Dr
Milwaukee, WI 53211-4508

2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1000

6900 N Port Washington Rd
Milwaukee, WI 53217-3921
Phone (414) 270-8100

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125050204ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Feb 9, 2022 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Feb 9, 2022 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Family Medicine CurrentSince Mar 8, 2021 Accepting new patients
Ascension NE Wisconsin, Inc CurrentSince Feb 9, 2022 Accepting new patients
Ascension NE Wisconsin, Inc CurrentSince Feb 9, 2022 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Jul 15, 2008 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Jul 15, 2008 Accepting new patients
Ascension Calumet Hospital, Inc CurrentSince Feb 9, 2022 Accepting new patients
Butte Des Morts Pathology, S.C. Current Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine Current Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine Past Accepting new patients

Locations

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

2320 N Lake Dr
Rm 3603
Milwaukee, WI 53211
Phone (414) 270-4932

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 11

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 1

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": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1710189121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON ROAD",
            "address_2": "CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-326-2378",
            "fax_number": "414-326-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 N LAKE DRIVE",
            "address_2": "ROOM 3603",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114507",
            "telephone_number": "414-270-4932",
            "fax_number": "414-291-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNENBAUM",
        "first_name": "DAVID",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125050204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.