Highlander Dermatology LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

H059290 Issued in WI

Legal business name

HIGHLANDER DERMATOLOGY LLC

Practice address

16650 W Bluemound Rd Ste 600
Brookfield, WI 53005-5970

Phone

(262) 290-4540

Fax

(262) 299-6435

NPI assigned

Mar 23, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Bradley T.J. Straka, M.D.NPI 1326031964

Title

Owner

Phone

(414) 899-2385

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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

• Bradley Theodore John Straka, MD

  • Dermatology Physician
  • Waukesha, WI
  • NPI 1326031964
  Medicare reassignment Care Compare group NPD Authorized official
• Kristina Ann Kleven, MD

  • Dermatology Physician
  • Brookfield, WI
  • NPI 1518950153
  Medicare reassignment Care Compare group NPD
• Melissa D McGuire, APNP

  • Family Nurse Practitioner
  • Greenfield, WI
  • NPI 1215992979
  Medicare reassignment Care Compare group NPD
• Tracy Lynn Nelson, APNP

  • Family Nurse Practitioner
  • Franklin, WI
  • NPI 1346499738
  Medicare reassignment Care Compare group NPD
• Allyssa Jean Clapsaddle, PA-C

  • Physician Assistant
  • Libertyville, IL
  • NPI 1982156485

  WI

  Medicare reassignment Care Compare group NPD
• Courtney A. Papp, PA-C

  • Physician Assistant
  • Waukesha, WI
  • NPI 1912942285
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1790216554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16650 W BLUEMOUND RD STE 600",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055970",
            "telephone_number": "262-290-4540",
            "fax_number": "262-299-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16650 W BLUEMOUND RD STE 600",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055970",
            "telephone_number": "262-290-4540",
            "fax_number": "262-299-6435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5600 W Rawson Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "WI",
            "postal_code": "531329279",
            "country_code": "US",
            "telephone_number": "262-290-4540",
            "fax_number": "262-299-6435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HIGHLANDER DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-23",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "STRAKA",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "T.J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-899-2385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WI",
            "license": "H059290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518950153",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215992979",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOLE OWNER NPI: 1326031964.  HIGHLANDER LLC TIN:",
            "identifier": "1326031964",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912942285",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1518950153",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912942285",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215992979",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1346499738",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326031964",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346499738",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy R. Hess, M.D.
• Marcy R Heuer, PHYSICAL THERAPIST
• Mehran Heydarpour, M.D.
• Leah Hibl, LPC
• Bridget High
• Elizabeth A Hilbelink, MD
• Elizabeth Hildebrandt Tesch, LPC-IT
• Joanne L Hill, MD
• Eric Hillmann, DPM
• Camron Hinckle, MS, LPC-IT

• Medical Specialty Clinic/Center in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Medical Specialty Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.