Individual provider Active NPI

Bedriye Y Tombuloglu, MD

  • General Practice Physician
  • Greenfield, WI
National Provider Identifier
1811083009
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
21422020 Issued in WI
Practice address
4325 S 60TH St
Greenfield, WI 53220
Phone
(414) 545-5500
Fax
(414) 545-5335
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 52D0391395 WI
General Practice Physician 208D00000X 21422020 WI Primary

Addresses

Primary practice location

4325 S 60TH St
Greenfield, WI 53220

Mailing address

4325 S 60TH St
Greenfield, WI 53220
Phone (414) 545-5500

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
I20111122000837 WI Practitioner - General Practice 0143494401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1968
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4325 S 60TH St
Unit 1
Greenfield, WI 53220-3505
Phone (414) 545-5500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52D0391395WIMDClinical Pathology/Laboratory Medicine Physician
21422020WIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutfi T Tombuloglu MD SC CurrentSince Nov 1, 2011 Accepting new patients

Locations

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

4325 S 60th St
Greenfield, WI 53220
Phone (414) 545-5500

4325 S 60th St
Unit 1
Milwaukee, WI 53220
Phone (414) 545-5500

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1811083009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 S 60TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53220",
            "telephone_number": "414-545-5500",
            "fax_number": "414-545-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 S 60TH ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53220",
            "telephone_number": "414-545-5500",
            "fax_number": "414-545-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMBULOGLU",
        "first_name": "BEDRIYE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "WI",
            "license": "52D0391395",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "21422020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.