Individual provider Active NPI

Bruce M Camitta, MD

  • Pediatric Hematology & Oncology Physician
  • Milwaukee, WI
National Provider Identifier
1881644318
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
19850 Issued in WI
Practice address
9000 W Wisconsin Ave
Children'S Hospital of Wisconsin
Milwaukee, WI 53226-3518
Phone
(414) 456-4170
Fax
(414) 456-6543
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 19850 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Children'S Hospital of Wisconsin
Milwaukee, WI 53226-3518

Mailing address

9000 W Wisconsin Ave
Children'S Hospital of Wisconsin
Milwaukee, WI 53226-3518
Phone (414) 456-4170

Other identifiers 2

IdentifierTypeStateIssuer
30148300MedicaidWI
002000111UOtherHUMANA

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

LicenseStateTypeSpecialty
19850WIMDPediatric Hematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1881644318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "CHILDREN'S HOSPITAL OF WISCONSIN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263518",
            "telephone_number": "414-456-4170",
            "fax_number": "414-456-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "CHILDREN'S HOSPITAL OF WISCONSIN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263518",
            "telephone_number": "414-456-4170",
            "fax_number": "414-456-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMITTA",
        "first_name": "BRUCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "WI",
            "license": "19850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30148300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002000111U",
            "state": null
        }
    ],
    "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 Aug 16, 2011; 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.