Individual provider Active NPI

Gabriel Tobias, MD

  • Plastic Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1841021847
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
84115-20 Issued in WI
Practice address
1155 N Mayfair Rd FL 2
Milwaukee, WI 53226-3462
Phone
(414) 955-1000
NPI assigned
Aug 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 84115-20 WI Primary

Addresses

Primary practice location

1155 N Mayfair Rd FL 2
Milwaukee, WI 53226-3462

Mailing address

1155 N Mayfair Rd FL 2
Milwaukee, WI 53226-3462
Phone (250) 808-1866

Other identifiers 1

IdentifierTypeStateIssuer
1841021847MedicaidWI

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
I20240828003752 WI Practitioner - Plastic and Reconstructive Surgery 9638618143 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84115-20WIMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Aug 1, 2024 Accepting new patients

Locations

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 805-5440

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

Interoperability endpoints

  • Direct secure messaging: gtobias138626@direct.chw.org

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": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1841021847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD FL 2",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263462",
            "telephone_number": "250-808-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD FL 2",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263462",
            "telephone_number": "414-955-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "84115-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841021847",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.