Individual provider Active NPI

Jitendra Baruah, MD, S.C.

  • Neurology Physician
  • Milwaukee, WI
National Provider Identifier
1720143894
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
22662-020 Issued in WI
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

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
30288000MedicaidWI

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
I20041008000458 WI Practitioner - Neurology 8729047519

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22662-020WIMDNeurology Physician
22662WIMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jitendra K Baruah MD SC Neurology CurrentSince Apr 15, 2004 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

Verify at the official NPI Registry.