Katayonsadat Tabatabaei Dakhili, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5171 Issued in WI

Practice address

130 W Bruce St
#200
Milwaukee, WI 53204-1667

Phone

(414) 384-1400

NPI assigned

Dec 19, 2012

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

Electronic endpoints 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ktabatabaeidakhili64080@direct.myadvocateaurora.org

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

• Aurora Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1912243924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W BRUCE ST",
            "address_2": "#200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532041667",
            "telephone_number": "414-384-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W BRUCE ST",
            "address_2": "#200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532041667",
            "telephone_number": "414-384-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABATABAEI DAKHILI",
        "first_name": "KATAYONSADAT",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100027445",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktabatabaeidakhili64080@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "130 W Bruce St",
            "address_2": "#200",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532041667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "130 W Bruce St",
            "address_2": "#200",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532041667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• T&JLLC D.B.a All for You Adult Family Home
• T&S Freight Dba T&S Adult Living Home
• T&W Transportation LLC
• Brian Ta, MD
• Neil Tabakin, M.D.
• Rachel Tabbert, CRNA
• Christine Hill Taber, LCSW
• Nadia Tabit
• Giulia Victoria Taccheri, MD
• Phaedra Maria Tachtatzis, MD

• Nurse Practitioner in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.

Verify at the official NPI Registry.