Active NPI
Jerico Isiderio Alvaran, M.D.
- Pediatrics Physician
- Milwaukee, WI
National Provider Identifier
1881806446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 50259-020
- Practice address
- 3727 W Wisconsin Ave
Milwaukee, WI 53208-3182 - Phone
- (414) 291-2626
- NPI assigned
- May 4, 2007
- Last updated
- Jun 14, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MT 184726 | PA | |
| Pediatrics Physician | 208000000X | 50259-020 | WI | Primary |
| General Practice Physician | 208D00000X | 50259 | WI |
Addresses
Primary practice location
3727 W Wisconsin Ave
Milwaukee, WI 53208-3182
Mailing address
2054 S 102ND St
Apt. 311B
West Allis, WI 53227-1375
Phone (262) 365-3725
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50259-020 | WI | MD | Pediatrics Physician |
| 50259 | WI | MD | General Practice Physician |
| MT 184726 | PA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Multi-Specialty | Current | Accepting new patients |
Locations
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420
Organizations & group practices 1
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.
-
- General Practice Physician
- Dallas, TX
- NPI 1750845863
Multi-Specialty, WI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1881806446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2054 S 102ND ST",
"address_2": "APT. 311B",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532271375",
"telephone_number": "262-365-3725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3727 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083182",
"telephone_number": "414-291-2626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALVARAN",
"first_name": "JERICO",
"middle_name": "ISIDERIO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "MT 184726",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "50259-020",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WI",
"license": "50259",
"primary": false
}
],
"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 Jun 14, 2021; 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.