Active NPI
Reginald C Bruskewitz, MD
- Urology Physician
- Madison, WI
National Provider Identifier
1790740470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 19188
- Practice address
- 600 Highland Ave
Madison, WI 53792 - Phone
- (608) 263-4757
- Fax
- (608) 265-2602
- NPI assigned
- Apr 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 19188 | WI | Primary |
Addresses
Primary practice location
600 Highland Ave
Madison, WI 53792
Mailing address
8007 Excelsior Dr
Madison, WI 53717
Phone (608) 829-5201
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19188 | WI | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210291200000",
"number": "1790740470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8007 EXCELSIOR DR",
"city": "MADISON",
"state": "WI",
"postal_code": "53717",
"telephone_number": "608-829-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "53792",
"telephone_number": "608-263-4757",
"fax_number": "608-265-2602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUSKEWITZ",
"first_name": "REGINALD",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2008-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WI",
"license": "19188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.