Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

Organization Active NPI Durable Medical Equipment & Medical Supplies · New Berlin, WI

NPI 1730635657 · NPPES record last updated Jul 19, 2024

Key facts

NPI
1730635657
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS, INC.
Practice address
4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone
(262) 798-7200
NPI assigned
Aug 31, 2016
Organization subpart
Yes
Parent organization (as reported)
FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS, INC.

Authorized official

Name
Amir Abbas Ghaferi, MD
Title
President & Ceo
Phone
(734) 660-4939

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 18

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 1,265

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

View all 1,265

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20171030000476 WI DME Supplier - Physician - General Practice 3678760063 Practice locations: New Berlin, WI

National Provider Directory

Tax ID family
Froedtert Med Coll of Wi (19 organizations share this tax ID)
Part of
Froedtert Med Coll of Wi

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

4805 S Moorland Rd
New Berlin, WI 53151-7401

Mailing address

N74W12501 Leatherwood CT Ste 103
Menomonee Falls, WI 53051-4490
Phone (414) 777-0417

Other names

  • Froedtert Physicians Partners, Inc. Other name

Other providers in New Berlin, WI

All providers in New Berlin, WI · Durable Medical Equipment & Medical Supplies in Wisconsin

Sources for this page

Verify at the official NPI Registry.