Active NPI
Stephen J Dufresne, M.D.
- Internal Medicine Physician
- Muskego, WI
National Provider Identifier
1861465791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 27446
- Practice address
- Prohealth Care Medical Centers-Muskego
S69 W15636 Janesville Road
Muskego, WI 53150 - Phone
- (262) 928-7000
- Fax
- (414) 422-2075
- NPI assigned
- Feb 10, 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27446 | WI | Primary |
Addresses
Primary practice location
Prohealth Care Medical Centers-Muskego
S69 W15636 Janesville Road
Muskego, WI 53150
Mailing address
Waukesha Health Care Inc.
N17 W24100 Riverwood Drive Suite 250
Waukesha, WI 53188-1177
Phone (262) 928-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30760900 | Medicaid | WI |
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 |
|---|---|---|---|
| 27446 | WI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Internal Medicine | Past | Accepting new patients |
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": "1139529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236902400000",
"number": "1861465791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WAUKESHA HEALTH CARE INC.",
"address_2": "N17 W24100 RIVERWOOD DRIVE SUITE 250",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531881177",
"telephone_number": "262-928-4100",
"fax_number": "262-928-5835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PROHEALTH CARE MEDICAL CENTERS-MUSKEGO",
"address_2": "S69 W15636 JANESVILLE ROAD",
"city": "MUSKEGO",
"state": "WI",
"postal_code": "53150",
"telephone_number": "262-928-7000",
"fax_number": "414-422-2075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFRESNE",
"first_name": "STEPHEN",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-10",
"last_updated": "2009-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "27446",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30760900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskego, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.