Active NPI
Jitendra Baruah, MD, S.C.
- Neurology Physician
- Milwaukee, WI
National Provider Identifier
1720143894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 22662-020
- Practice address
- 3201 S 16TH St
Suite 200
Milwaukee, WI 53215-4537 - Phone
- (414) 384-5581
- Fax
- (414) 384-5644
- NPI assigned
- Dec 27, 2006
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 22662-020 | WI | Primary |
Addresses
Primary practice location
3201 S 16TH St
Suite 200
Milwaukee, WI 53215-4537
Mailing address
3201 S 16TH St
Suite 200
Milwaukee, WI 53215-4537
Phone (414) 384-5581
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30288000 | Medicaid | WI |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041008000458 | WI | Practitioner - Neurology | 8729047519 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22662-020 | WI | MD | Neurology Physician |
| 22662 | WI | MD | Surgical Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jitendra K Baruah MD SC | Neurology | Current | Accepting new patients |
Locations
1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314
3201 S 16th St
Ste 200
Milwaukee, WI 53215
Phone (414) 384-5581
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770854400000",
"number": "1720143894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 S 16TH ST",
"address_2": "SUITE 200",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532154537",
"telephone_number": "414-384-5581",
"fax_number": "414-384-5644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 S 16TH ST",
"address_2": "SUITE 200",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532154537",
"telephone_number": "414-384-5581",
"fax_number": "414-384-5644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARUAH",
"first_name": "JITENDRA",
"name_prefix": "Dr.",
"credential": "MD, S.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2026-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WI",
"license": "22662-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30288000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.