Promise Dzakpasu, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

36766 Issued in WI

Practice address

4655 N Port Washington Rd Ste 200
Glendale, WI 53212-1076

Phone

(414) 247-9530

Fax

(414) 247-1875

NPI assigned

Jun 28, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: pdzakpasu7509@direct.chw.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Medical Group

  dba Glendale Pediatrics

  • Pediatrics Physician
  • Glendale, WI
  • NPI 1134394471
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1881691418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 N PORT WASHINGTON RD STE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121076",
            "telephone_number": "414-247-9530",
            "fax_number": "414-247-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZAKPASU",
        "first_name": "PROMISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "36766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32159400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne Duncan, M.A. CCC-SLP
• Paul Joseph Dupont, PHD
• Dycora Transitional Health - Glendale LLC
• Dycora Transitional Health - Milwaukee LLC
• Dyno Energy Services LLC
• Bonnie Eckl, APNP
• Alwin Edakkunnathu, O.D.
• Elements of Health LLC
• Elite Home Health Care Inc.
• Elitecare Home Care Agency LLC

• Pediatrics Physician in Glendale, WI
• Providers in Glendale, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.