Individual provider Active NPI

Charles M Grade, MD

  • Psychiatry Physician
  • Wauwatosa, WI
National Provider Identifier
1790890796
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
32662 Issued in WI
Practice address
7845 Harwood Ave
Wauwatosa, WI 53213-2523
Phone
(414) 270-1011
Fax
(414) 270-1031
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 32662 WI Primary

Addresses

Primary practice location

7845 Harwood Ave
Wauwatosa, WI 53213-2523

Mailing address

7845 Harwood Ave
Wauwatosa, WI 53213-2523
Phone (414) 270-1011

Other practice location 1

2020 W Wells St
Milwaukee, WI 53233-2720
Phone (414) 476-9675

Other identifiers 1

IdentifierTypeStateIssuer
31874500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081213000232 WI Practitioner - PsychiatryPractitioner - Addiction Medicine 2668534355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
University of Wisconsin School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7845 Harwood Ave
Wauwatosa, WI 53213-2523
Phone (414) 270-1011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32662WIMDPsychiatry Physician

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1790890796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7845 HARWOOD AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132523",
            "telephone_number": "414-270-1011",
            "fax_number": "414-270-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7845 HARWOOD AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132523",
            "telephone_number": "414-270-1011",
            "fax_number": "414-270-1031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 W Wells St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532332720",
            "country_code": "US",
            "telephone_number": "414-476-9675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRADE",
        "first_name": "CHARLES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "32662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31874500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.