Individual provider Active NPI

Michael G Olaciregui, M.D.

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1811094972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42851-020 Issued in WI
Practice address
573 W Lincoln Ave
Milwaukee, WI 53207-1141
Phone
(414) 385-9801
Fax
(414) 385-9803
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42851-020 WI Primary

Addresses

Primary practice location

573 W Lincoln Ave
Milwaukee, WI 53207-1141

Mailing address

PO Box 11430
Milwaukee, WI 53211-0430
Phone (414) 962-9070

Other identifiers 1

IdentifierTypeStateIssuer
34071200MedicaidWI

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
I20050503000225 WI Practitioner - Internal Medicine 0840238762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interpedia SCGroup PAC ID 5698856375, 5 clinicians

Practice addresses (Care Compare)

1238 S Cesar E Chavez Dr
Milwaukee, WI 53204-2267
Phone (414) 645-6665

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42851-020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interpedia, S.C. CurrentSince Jul 1, 2022 Accepting new patients

Locations

1238 S Cesar E Chavez Dr
Milwaukee, WI 53204
Phone (414) 645-6665

216 Green Bay Rd
Ste 109
Thiensville, WI 53092
Phone (262) 241-5414

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811094972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11430",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532110430",
            "telephone_number": "414-962-9070",
            "fax_number": "414-962-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 W LINCOLN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532071141",
            "telephone_number": "414-385-9801",
            "fax_number": "414-385-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLACIREGUI",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "42851-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34071200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.