Active NPI
Maria Estelita Quejada, MD
- Pediatrics Physician
- Kenosha, WI
National Provider Identifier
1851408173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35105
- Practice address
- 6809 122ND Ave
Kenosha, WI 53142-7335 - Phone
- (262) 891-6600
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35105 | WI | Primary |
Addresses
Primary practice location
6809 122ND Ave
Kenosha, WI 53142-7335
Mailing address
6809 122ND Ave
Kenosha, WI 53142-7335
Phone (262) 891-6600
Other practice location 1
8375 S Howell Ave
Oak Creek, WI 53154-8344
Phone (414) 764-5728
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32361600 | Medicaid | WI |
Other names 1
- Maria Estelita F G Quejada
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 |
|---|---|---|---|
| 35105 | WI | MD | Pediatrics Physician |
Interoperability endpoints
- mquejada12397@direct.chw.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1851408173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6809 122ND AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531427335",
"telephone_number": "262-891-6600",
"fax_number": "262-891-6602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6809 122ND AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531427335",
"telephone_number": "262-891-6600"
}
],
"practiceLocations": [
{
"address_1": "8375 S Howell Ave",
"address_purpose": "LOCATION",
"city": "Oak Creek",
"state": "WI",
"postal_code": "531548344",
"country_code": "US",
"telephone_number": "414-764-5728",
"fax_number": "414-164-6954",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "QUEJADA",
"first_name": "MARIA",
"middle_name": "ESTELITA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "35105",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32361600",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARIA ESTELITA",
"last_name": "QUEJADA",
"middle_name": "F G",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Kenosha, WI
- Pushparanee Babusukumar M.D.S.C.
- Mohammed A Qadeer, MD
- Quality Addiction Management Inc (Kenosha Comprehensive Treatment Center)
- Quality Addiction Management Inc (Kenosha Comprehensive Treatment Center)
- Jawaid Quddus, MD, PHD
- Amanda Quinonez, APNP
- Racine Kenosha Community Action Agency
- Leah Radewan, MS, CF-SLP
- Christine Radke, DPT
- Michael R Radke, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.