Individual provider Active NPI

Abdul Hafeez, MD

  • Internal Medicine Physician
  • Wauwatosa, WI
National Provider Identifier
1720010473
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41642 Issued in WI
Practice address
2727 N Mayfair Rd
Suite I
Wauwatosa, WI 53222-4400
Phone
(414) 773-6300
NPI assigned
Jul 6, 2006
Last updated
Jun 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 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 41642 WI Primary

Addresses

Primary practice location

2727 N Mayfair Rd
Suite I
Wauwatosa, WI 53222-4400

Mailing address

4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 773-6300

Other identifiers 1

IdentifierTypeStateIssuer
32622900MedicaidWI

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
I20051123000089 WI Practitioner - Internal Medicine 7012937857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisconsin Health FundGroup PAC ID 3072401298, 27 clinicians

Practice addresses (Care Compare)

10950 W Capitol Dr
Wauwatosa, WI 53222-1110
Phone (414) 464-4460

13950 W Capitol Dr
Brookfield, WI 53005-2441
Phone (414) 464-4460

6200 W Bluemound Rd
Milwaukee, WI 53213-4145
Phone (414) 771-5600

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41642WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Current Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Nov 1, 2005 Accepting new patients
Wisconsin Health Fund CurrentSince Oct 1, 2001 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Nov 1, 2005 Accepting new patients
Wisconsin Health Fund Past Accepting new patients

Locations

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

6200 W Bluemound Rd
Milwaukee, WI 53213
Phone (414) 479-3668

8430 W Capitol Dr
Ste 103CB
Milwaukee, WI 53222
Phone (414) 464-1000

10950 W Capitol Dr
Wauwatosa, WI 53222
Phone (414) 464-4460

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1720010473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-773-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 N MAYFAIR RD",
            "address_2": "SUITE I",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224400",
            "telephone_number": "414-773-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEEZ",
        "first_name": "ABDUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "41642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32622900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.