Samuel Kress Corbo, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

69787 Issued in WI

Practice address

9200 W Wisconsin Ave
Milwaukee, WI 53226

Phone

(414) 805-6450

Fax

(414) 805-6464

NPI assigned

Jul 30, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: scorbomd258462@direct.froedtert.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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Emergency Medicine

  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1881002129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        },
        {
            "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": "53226",
            "telephone_number": "414-805-6450",
            "fax_number": "414-805-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBO",
        "first_name": "SAMUEL",
        "middle_name": "KRESS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-30",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "R3458",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "TP978",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "69787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881002129",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Corado, DDS
• Jasna Coralic, MD
• Alecia Corbett, MSW
• Brooke Nicole Corbett, AGACNP-BC
• Lisa Marie Corbine, RN
• Delia Ivette Corchado
• Jennifer Corcoran, PA-C
• Justin Corcoran, M.D.
• Nicholas Corcoran
• Nora Rene Cord, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.

Verify at the official NPI Registry.