Active NPI
Eric J Walbergh, MD
- Critical Care Medicine (Anesthesiology) Physician
- Milwaukee, WI
National Provider Identifier
1710939319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Anesthesiology) Physician
- License
- 28113
- Practice address
- 9000 W Wisconsin Ave
Pediatric Anesthesiology
Milwaukee, WI 53226-4874 - Phone
- (414) 266-3560
- Fax
- (414) 266-6092
- NPI assigned
- May 16, 2006
- Last updated
- Sep 6, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | 28113 | WI | Primary |
Addresses
Primary practice location
9000 W Wisconsin Ave
Pediatric Anesthesiology
Milwaukee, WI 53226-4874
Mailing address
9000 W Wisconsin Ave
Pediatric Anesthesiology
Milwaukee, WI 53226-4874
Phone (414) 266-3560
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30749100 | Medicaid | WI | |
| 1710939319 | Medicaid | WI | |
| 002000328Y | Other | HUMANA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28113 | WI | MD | Critical Care Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1710939319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "PEDIATRIC ANESTHESIOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-3560",
"fax_number": "414-266-6092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "PEDIATRIC ANESTHESIOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-3560",
"fax_number": "414-266-6092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALBERGH",
"first_name": "ERIC",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "WI",
"license": "28113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30749100",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1710939319",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "002000328Y",
"state": null
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.