Active NPI
Sara Haitham Matloub
- Internal Medicine Physician
- Milwaukee, WI
National Provider Identifier
1861070237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- M3417889550104
- Practice address
- 900 N 92ND St
Milwaukee, WI 53226-1202 - Phone
- (414) 805-3000
- NPI assigned
- Mar 29, 2021
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | M3417889550104 | WI | Primary |
Addresses
Primary practice location
900 N 92ND St
Milwaukee, WI 53226-1202
Mailing address
N8W28814 Shepherds Way
Waukesha, WI 53188-9499
Phone (262) 271-2823
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210921001194 | WI | Order and Referring Only - General Surgery | 1759788615 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M3417889550104 | WI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617235200000",
"number": "1861070237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N8W28814 SHEPHERDS WAY",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531889499",
"telephone_number": "262-271-2823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N 92ND ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532261202",
"telephone_number": "414-805-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLOUB",
"first_name": "SARA",
"middle_name": "HAITHAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-29",
"last_updated": "2021-04-01",
"certification_date": "2021-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "M3417889550104",
"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 Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.