Individual provider Active NPI

Glenn Francis Ragalie, M.D.

  • Pulmonary Disease Physician
  • Wauwatosa, WI
National Provider Identifier
1740382555
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
21819 Issued in WI
Practice address
1155 N Honey Creek Pkwy
Wauwatosa, WI 53213-3189
Phone
(414) 615-5936
Fax
(414) 615-5927
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 21819 WI Primary

Addresses

Primary practice location

1155 N Honey Creek Pkwy
Wauwatosa, WI 53213-3189

Mailing address

1621 Church St
Wauwatosa, WI 53213-2541
Phone (414) 258-7498

Other identifiers 1

IdentifierTypeStateIssuer
30330900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1740382555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 CHURCH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132541",
            "telephone_number": "414-258-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N HONEY CREEK PKWY",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532133189",
            "telephone_number": "414-615-5936",
            "fax_number": "414-615-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGALIE",
        "first_name": "GLENN",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "21819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30330900",
            "state": "WI"
        }
    ],
    "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 Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.