Individual provider Active NPI

Donald J Brescia, MD

  • Cardiovascular Disease Physician
  • Oshkosh, WI
National Provider Identifier
1740275122
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
24790 Issued in WI
Practice address
2700 W 9TH Ave
Ste 106
Oshkosh, WI 54904-7247
Phone
(920) 236-1750
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 24790 WI Primary

Addresses

Primary practice location

2700 W 9TH Ave
Ste 106
Oshkosh, WI 54904-7247

Mailing address

2700 W 9TH Ave
Ste 106
Oshkosh, WI 54904-7247
Phone (920) 236-1750

Other identifiers 1

IdentifierTypeStateIssuer
30456700MedicaidWI

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
I20040414000755 WI Practitioner - Cardiovascular Disease (Cardiology) 9537153218

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24790WIMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1740275122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W 9TH AVE",
            "address_2": "STE 106",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047247",
            "telephone_number": "920-236-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W 9TH AVE",
            "address_2": "STE 106",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047247",
            "telephone_number": "920-236-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESCIA",
        "first_name": "DONALD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "24790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30456700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.