Organization Active NPI

Ninette a Nassif MD SC

  • Internal Medicine Physician
  • Wauwatosa, WI
National Provider Identifier
1720249592
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29531 Issued in WI
Legal business name
NINETTE A NASSIF MD SC
Practice address
10625 W North Ave Ste 201
Wauwatosa, WI 53226-2315
Phone
(414) 778-1451
NPI assigned
Jun 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Authorized official

Name
Ninette A NassifNPI 1942269022
Title
Owner
Phone
(414) 778-1451

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 29531 WI Primary

Addresses

Primary practice location

10625 W North Ave Ste 201
Wauwatosa, WI 53226-2315

Mailing address

10625 W North Ave Ste 201
Wauwatosa, WI 53226-2315
Phone (414) 778-1451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080725000259 WI Part B Supplier - Clinic/Group Practice 5294808176 Receives reassigned benefits from 1 practitioner
Practice locations: Wauwatosa, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1023807Ninette a Nassif MD SC10625 West North Ave, Ste 201, Wauwatosa, WI 53226Certificate of waiverMar 24, 2028

National Provider Directory

National Provider Directory

Locations

10625 W North Ave
Ste 201
Wauwatosa, WI 53226
Phone (414) 727-1117

2300 N Mayfair Rd
Ste 755
Wauwatosa, WI 53226
Phone (414) 258-0670

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1720249592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 201",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-778-1451",
            "fax_number": "414-778-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 201",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-778-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINETTE A NASSIF MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "NASSIF",
        "authorized_official_first_name": "NINETTE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-778-1451"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "29531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.