Active NPI
Sidney Herszenson, M.D.
- Dermatology Physician
- Milwaukee, WI
National Provider Identifier
1841264074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 18537
- Practice address
- 2600 N Mayfair Rd
Suite 810
Milwaukee, WI 53226-1309 - Phone
- (414) 771-1122
- Fax
- (414) 771-1352
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 18537 | WI | Primary |
Addresses
Primary practice location
2600 N Mayfair Rd
Suite 810
Milwaukee, WI 53226-1309
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (866) 630-9882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18537 | WI | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology Services, SC | Dermatology | Current | Accepting new patients |
Locations
5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089
21425 Spring St
Union Grove, WI 53182
Phone (262) 878-2411
3077 N Mayfair Rd
Ste 305
Wauwatosa, WI 53222
Phone (414) 258-3500
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": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392595200000",
"number": "1841264074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 YORK ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204630",
"telephone_number": "866-630-9882",
"fax_number": "920-683-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 N MAYFAIR RD",
"address_2": "SUITE 810",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532261309",
"telephone_number": "414-771-1122",
"fax_number": "414-771-1352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERSZENSON",
"first_name": "SIDNEY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2014-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WI",
"license": "18537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.