NPIMap

Organization Active NPI

DRS Wagner Goodman Pasch and Packman LTD

  • Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1780684647
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
DRS WAGNER GOODMAN PASCH AND PACKMAN LTD
Practice address
5150 N Port Washington Rd
Suite 151
Milwaukee, WI 53217-5474
Phone
(414) 332-1000
Fax
(414) 332-1005
NPI assigned
Jul 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Joseph Jay Goodman, MDNPI 1841299773
Title
President
Phone
(414) 332-1000

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X WI Primary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X WI

Addresses

Primary practice location

5150 N Port Washington Rd
Suite 151
Milwaukee, WI 53217-5474

Mailing address

5150 N Port Washington Rd
Suite 151
Milwaukee, WI 53217-5474
Phone (414) 332-1000

Other identifiers 1

IdentifierTypeStateIssuer
32705400MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780684647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD",
            "address_2": "SUITE 151",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175474",
            "telephone_number": "414-332-1000",
            "fax_number": "414-332-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD",
            "address_2": "SUITE 151",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175474",
            "telephone_number": "414-332-1000",
            "fax_number": "414-332-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS WAGNER GOODMAN PASCH AND PACKMAN LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-332-1000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32705400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.