Individual provider Active NPI

Brintha F Vasagar, MD, MPH

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1780926188
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C1-0013090 Issued in DE
Practice address
3522 W Lisbon Ave
Milwaukee, WI 53208-1953
Phone
(414) 935-8000
Fax
(414) 344-3350
NPI assigned
Mar 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C1-0013090 DE Primary

Addresses

Primary practice location

3522 W Lisbon Ave
Milwaukee, WI 53208-1953

Mailing address

3522 W Lisbon Ave
Milwaukee, WI 53208-1953
Phone (414) 935-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161222000498 SC Practitioner - Family Practice 5991939613 Reassigns benefits to 2 organizations
I20240827000946 WI Practitioner - Family Practice 5991939613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3522 W Lisbon Ave
Milwaukee, WI 53208-1953
Phone 41493580001437

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0013090DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waccamaw Community Hospital CurrentSince Jul 1, 2017 Accepting new patients
Progressive Community Health Centers, Inc. Family Medicine CurrentSince Jul 14, 2024 Accepting new patients
Georgetown Memorial Hospital CurrentSince Jul 1, 2017 Accepting new patients
Progressive Community Health Centers, Inc. Family Medicine CurrentSince Jul 14, 2024 Accepting new patients
Georgetown Memorial Hospital CurrentSince Jul 1, 2017 Accepting new patients

Locations

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

1452 N 7th St
Fl 2
Milwaukee, WI 53205
Phone (414) 935-8000

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

3522 W Lisbon Ave
Milwaukee, WI 53208
Phone (414) 935-8000

Interoperability endpoints

  • Direct secure messaging: bvasagar707227@direct.ochin.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1363996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1780926188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081953",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081953",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASAGAR",
        "first_name": "BRINTHA",
        "middle_name": "F",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-23",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0013090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.