NPIMap

Individual provider Active NPI

John David Bivins II, M.D.

  • Family Medicine Physician
  • Greendale, WI
National Provider Identifier
1841230463
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45682-020 Issued in WI
Practice address
6220 W Loomis Rd
Greendale, WI 53129-2448
Phone
(414) 423-0555
NPI assigned
Jun 8, 2006
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45682-020 WI Primary

Addresses

Primary practice location

6220 W Loomis Rd
Greendale, WI 53129-2448

Mailing address

6220 W Loomis Rd
Greendale, WI 53129-2448
Phone (414) 423-0555

Other identifiers 1

IdentifierTypeStateIssuer
34417600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070827000178 WI Practitioner - Family Practice 4082706767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002
Phone (262) 255-2500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45682-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Family Medicine Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 2, 2023 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Aug 27, 2007 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Aug 27, 2007 Accepting new patients
DRS. Massaro & Kalenak S C Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 2, 2023 Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine Current Accepting new patients
Sacred Heart Rehabilitation Institute, Inc Past Accepting new patients

Locations

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

6220 W Loomis Rd
Greendale, WI 53129
Phone (414) 423-0555

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500

1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998

1414 N Taylor Dr
Ste 210
Sheboygan, WI 53081
Phone (262) 243-2500

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • Direct secure messaging: jbivins150716@direct.froedtert.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1841230463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 W LOOMIS RD",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292448",
            "telephone_number": "414-423-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 W LOOMIS RD",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292448",
            "telephone_number": "414-423-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVINS",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-07-05",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "45682-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34417600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greendale, WI

Sources for this page

Verify at the official NPI Registry.