Individual provider Active NPI

Craig A Siverhus, M.D.

  • Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1841224128
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
30501 Issued in WI
Practice address
2350 N Lake Dr
Suite 304
Milwaukee, WI 53211-4528
Phone
(414) 298-7222
Fax
(414) 298-7229
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 30501 WI Primary

Addresses

Primary practice location

2350 N Lake Dr
Suite 304
Milwaukee, WI 53211-4528

Mailing address

788 N Jefferson St
Suite 300/Attn. Kaaren Butzen
Milwaukee, WI 53202-3718
Phone (414) 272-8950

Other identifiers 1

IdentifierTypeStateIssuer
1841224128MedicaidWI

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
I20080425000322 WI Practitioner - General SurgeryPractitioner - Vascular Surgery 7315025715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Medical College of Wisconsin, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Medical Affiliates IncGroup PAC ID 5991606337, 86 clinicians

Practice addresses (Care Compare)

2350 N Lake Dr
Suite 304
Milwaukee, WI 53211-4528
Phone (414) 298-7222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30501WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Medical Affiliates, Inc. CurrentSince May 1, 2008 Accepting new patients

Locations

7423 Solutions Ctr
Chicago, IL 60677

13133 N Port Washington Rd
Ste 224
Mequon, WI 53097
Phone (262) 240-0070

13133 N Port Washington Rd
Ste G01
Mequon, WI 53097
Phone (262) 243-2500

2350 N Lake Dr
Ste 304
Milwaukee, WI 53211
Phone (414) 298-7220

2015 E Newport Ave
Ste 305
Milwaukee, WI 53211
Phone (414) 961-0531

788 N Jefferson St
Ste 401
Milwaukee, WI 53202
Phone (414) 226-4020

788 N Jefferson St
Ste 300ATTN
Milwaukee, WI 53202

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1841224128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST",
            "address_2": "SUITE 300/ATTN. KAAREN BUTZEN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023718",
            "telephone_number": "414-272-8950",
            "fax_number": "414-272-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "address_2": "SUITE 304",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-298-7222",
            "fax_number": "414-298-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVERHUS",
        "first_name": "CRAIG",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "30501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841224128",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.