Individual provider Active NPI

Michael S Bartelt, DDS

  • General Practice Dentistry
  • West Allis, WI
National Provider Identifier
1902836596
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5001758-015 Issued in WI
Practice address
555 S 108TH St
West Allis, WI 53214-1100
Phone
(414) 566-6400
Fax
(414) 566-3900
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5001758-015 WI Primary

Addresses

Primary practice location

555 S 108TH St
West Allis, WI 53214-1100

Mailing address

555 S 108TH St
West Allis, WI 53214-1100
Phone (414) 566-6400

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190619000025 WI Order and Referring Only - DentistPractitioner - Dentist 0840524278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5001758-015WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902836596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S 108TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532141100",
            "telephone_number": "414-566-6400",
            "fax_number": "414-566-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 108TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532141100",
            "telephone_number": "414-566-6400",
            "fax_number": "414-566-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTELT",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001758-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.