Individual provider Active NPI

Anilkumar Doniparthi, MD

  • Internal Medicine Physician
  • Wauwatosa, WI
National Provider Identifier
1952358228
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38316 Issued in WI
Practice address
830 N 109TH St
Ste 1
Wauwatosa, WI 53226-3754
Phone
(414) 777-1811
Fax
(414) 777-1812
NPI assigned
May 30, 2006
Last updated
Dec 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38316 WI Primary

Addresses

Primary practice location

830 N 109TH St
Ste 1
Wauwatosa, WI 53226-3754

Mailing address

830 N 109TH St
Ste 1
Wauwatosa, WI 53226-3754
Phone (414) 777-1811

Other identifiers 1

IdentifierTypeStateIssuer
32296000MedicaidWI

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
I20040211000791 WI Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 4587558465 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Internal Medicine Associates Inc Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine Past Accepting new patients

Locations

3415 Sheridan Rd
Kenosha, WI 53140
Phone (262) 633-4343

4600 W Loomis Rd
Ste 101
Milwaukee, WI 53220
Phone (414) 488-1818

7733 W Burleigh St
Milwaukee, WI 53222
Phone (262) 328-4232

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Legacy Hospice Cares LLCElm Grove, WI, CCN 521602 Hospice 5% Or Greater Direct Ownership Interest (25%)
Corporate Director (25%)
W-2 Managing Employee (25%)
Oct 30, 2017
Oct 30, 2017
Oct 30, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1952358228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 N 109TH ST",
            "address_2": "STE 1",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263754",
            "telephone_number": "414-777-1811",
            "fax_number": "414-777-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 N 109TH ST",
            "address_2": "STE 1",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263754",
            "telephone_number": "414-777-1811",
            "fax_number": "414-777-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONIPARTHI",
        "first_name": "ANILKUMAR",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "38316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32296000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.