Individual provider Active NPI

Razaan Mateen

  • Anesthesiology Physician
  • Milwaukee, WI
National Provider Identifier
1811626880
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
13811 Issued in GA
Practice address
9200 W Wisconsin Ave # P347
Milwaukee, WI 53226-3522
Phone
(414) 805-6102
NPI assigned
Jun 6, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 13811 GA Primary

Addresses

Primary practice location

9200 W Wisconsin Ave # P347
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave # P347
Milwaukee, WI 53226-3522
Phone (414) 805-6102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1811626880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE # P347",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE # P347",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEEN",
        "first_name": "RAZAAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "13811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.