Siddhanth Ahluwalia, MD
Individual provider Active NPI Anesthesiology Physician · Marinette, WI
NPI 1851813489 · NPPES record last updated Nov 25, 2024
Key facts
- NPI
- 1851813489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 84576-20 (WI)
- Practice address
- 3003 University Dr
Marinette, WI 54143-4110 - Phone
- (715) 735-4200
- NPI assigned
- Jul 14, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Medical Group, Inc.
Practice addresses (Care Compare)
3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-6621
Hospital & facility affiliations
- Aurora Medical Center Bay Area
- Mercy Medical Center - Cedar Rapids
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210723003042 | IA | Practitioner - Anesthesiology | 1153670732 | Reassigns benefits to 1 organization |
| I20241017001117 | WI | Practitioner - Anesthesiology | 1153670732 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-47850 | IA | MD | Anesthesiology Physician |
| 84576-20 | WI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients |
Locations
3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
Interoperability endpoints
- sahluwalia410494@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD-47850 | IA | |
| Anesthesiology Physician | 207L00000X | 125.073242 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301112146 | MI | |
| Anesthesiology Physician | 207L00000X | 84576-20 | WI | Yes |
Addresses
Primary practice location
3003 University Dr
Marinette, WI 54143-4110
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
3421 W 9th St
Department of Anesthesiology
Waterloo, IA 50702-5401
Phone (319) 272-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100290609 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sahluwalia410494@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Marinette, WI
- Nora Abel
- Amjed Yousef Abu Muhanna
- Danielle Adams
- Advanced Physical Therapy & Sports Medicine SC
- Thea J Aguon
- Emmanouil Alimpertis
- American Lutheran Church-Northland Luthern Services for the Elderly, I
- Amy L Anderson
- Carrie Anderson
- Hayward Anderson
All providers in Marinette, WI · Anesthesiology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.