Individual provider Active NPI

Matthew G Fleming, MD

  • Dermatology Physician
  • Milwaukee, WI
National Provider Identifier
1962453787
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
36238 Issued in WI
Practice address
4324 W Bradley Rd
Milwaukee, WI 53223-3710
Phone
(414) 446-3450
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 36238 WI
Dermatology Physician 207N00000X 36238 WI Primary

Addresses

Primary practice location

4324 W Bradley Rd
Milwaukee, WI 53223-3710

Mailing address

PO Box 1003
Wichita, KS 67201-1003

Other identifiers 2

IdentifierTypeStateIssuer
32099900MedicaidWI
002000162ROtherHUMANA

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
I20091202000491 WI Practitioner - PathologyPractitioner - Dermatology 8123167285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Dermatology Associates PCGroup PAC ID 3072403799, 84 clinicians

Practice addresses (Care Compare)

23 Hampton Rd
Exeter, NH 03833-4807
Phone (978) 691-5690

Merit-based Incentive Payment System (MIPS)

Final score
91.13 of 100Reported as group
Quality
90.63
Improvement activities
40
Cost
82.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36238WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Dermatologists, SC Dermatology CurrentSince Nov 10, 2014 Accepting new patients
Affiliated Dermatologists Dermatology CurrentSince Nov 10, 2014 Accepting new patients
Affiliated Dermatologists SC Dermatology Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Past Accepting new patients

Locations

13800 W North Ave
Ste 100
Brookfield, WI 53005
Phone (262) 754-4488

N96W17035 Division Rd
Germantown, WI 53022
Phone (262) 754-4488

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1962453787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1003",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672011003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4324 W BRADLEY RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532233710",
            "telephone_number": "414-446-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "MATTHEW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WI",
            "license": "36238",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "36238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32099900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002000162R",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.