Individual provider Active NPI

Marilyn J Sincaban, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Milwaukee, WI
National Provider Identifier
1861582215
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
37168 Issued in WI
Practice address
1555 S Layton Blvd
Milwaukee, WI 53215-1924
Phone
(414) 385-6600
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 37168 WI Primary

Addresses

Primary practice location

1555 S Layton Blvd
Milwaukee, WI 53215-1924

Mailing address

2530 Chanticleer CT
Brookfield, WI 53045
Phone (262) 780-9642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110421000194 WI Practitioner - Geriatric Medicine 9133304975 Reassigns benefits to 2 organizations
I20220518001125 WI Practitioner - Internal Medicine 9133304975 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37168WIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Healthcare Corporation Midwest CurrentSince Dec 13, 2022 Accepting new patients
Agrace Palliative Care LLC CurrentSince Apr 18, 2022 Accepting new patients
Vitas Healthcare Corporation Midwest CurrentSince Jan 1, 2022 Accepting new patients

Locations

5395 E Cheryl Pkwy
Fitchburg, WI 53711
Phone (608) 276-4660

12000 W Park Pl
Ste 200
Milwaukee, WI 53224
Phone (414) 257-2600

Organizations & group practices 3

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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1861582215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHANTICLEER CT",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53045",
            "telephone_number": "262-780-9642",
            "fax_number": "262-780-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S LAYTON BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151924",
            "telephone_number": "414-385-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINCABAN",
        "first_name": "MARILYN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "37168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.