Fernando T. Itable, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35585 Issued in WI

Practice address

2745 W Layton Ave
Suite 3201
Milwaukee, WI 53221-2651

Phone

(414) 281-0050

Fax

(414) 281-0773

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Saint Louis University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Independent Physicians of Wisconsin LLCGroup PAC ID 3274842034, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fernando.itable.1@18758.direct.athenahealth.com

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.

• Independent Physicians of Wisconsin, LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1871975920
  Medicare reassignment Care Compare group NPD
• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment NPD
• Independent Physicians of Wisconsin, LLC

  • Durable Medical Equipment & Medical Supplies
  • Kenosha, WI
  • NPI 1588255996
  NPD
• Commonwealth Medical Group, LLC

  • Internal Medicine Physician
  • West Allis, WI
  • NPI 1477500361
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension SE Wisconsin Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1871586560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689711",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532689711",
            "telephone_number": "414-456-3100",
            "fax_number": "414-456-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 W LAYTON AVE",
            "address_2": "SUITE 3201",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212651",
            "telephone_number": "414-281-0050",
            "fax_number": "414-281-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITABLE",
        "first_name": "FERNANDO",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "35585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32260500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abdalah Ismail, MD
• Zainul Ismail, PHARMD
• Mohameddeq A Isse
• Alexandra C Istl
• Jamie M Istwan, PT
• Rodrigo Itable, M.D.
• Doha Itani
• Vladimir Ivanovic, M.D.
• Karen Ann (a.) Ivantic, N.P.
• Andrew Jack Iverson, PHARMD

• Internal Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.