Individual provider Active NPI

Jerico Isiderio Alvaran, M.D.

  • Pediatrics Physician
  • Milwaukee, WI
National Provider Identifier
1881806446
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
50259-020 Issued in WI
Practice address
3727 W Wisconsin Ave
Milwaukee, WI 53208-3182
Phone
(414) 291-2626
NPI assigned
May 4, 2007
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071026000728 WI Practitioner - Pediatric Medicine 5799872495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50259-020WIMDPediatrics Physician
50259WIMDGeneral Practice Physician
MT 184726PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Multi-Specialty CurrentSince Sep 23, 2023 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.

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

Verify at the official NPI Registry.