Individual provider Active NPI

Flavio Cavallari

  • Perfusionist
  • Milwaukee, WI
National Provider Identifier
1871132993
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PerfusionistTaxonomy code 242T00000X
License
223-18 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 955-6900
Fax
(414) 955-0079
NPI assigned
Jan 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perfusionist 242T00000X 223-18 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

935 N Cass St Apt 46
Milwaukee, WI 53202-3648
Phone (920) 412-4111

Other practice location 1

8701 W Watertown Plank Rd
Wauwatosa, WI 53226-3548
Phone (414) 955-4357

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
223-18WIMDPerfusionist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1871132993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 N CASS ST APT 46",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023648",
            "telephone_number": "920-412-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-955-6900",
            "fax_number": "414-955-0079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 W Watertown Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532263548",
            "country_code": "US",
            "telephone_number": "414-955-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVALLARI",
        "first_name": "FLAVIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "WI",
            "license": "223-18",
            "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 Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.