Mirley Bujan Carreno, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

100787-851 Issued in WI

Practice address

2400 W Villard Ave
Milwaukee, WI 53209-4901

Phone

(414) 527-8415

NPI assigned

Jun 12, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1902648751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 N LYDELL AVE UNIT 502",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532174598",
            "telephone_number": "760-996-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W VILLARD AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532094901",
            "telephone_number": "414-527-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUJAN CARRENO",
        "first_name": "MIRLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "100787-851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Building Bridges LLC
• Building Love and Support for Moms
• Building My Brilliance LLC
• Building New Pathways, LLC
• Osayd S Buirat, DO
• Cynthia S Bujanovich, RN
• Brittni Ann Bukacek, PT DPT
• Elizabeth Ann Bukowy
• Timothy Robert Bullion, D.D.S.
• Lisa Marie Bullis, MSN, APNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.