Marie L Nakata, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

31851020 Issued in WI

Practice address

17100 W North Ave
Suite 200
Brookfield, WI 53005-4436

Phone

(262) 784-3800

Fax

(262) 784-7936

NPI assigned

Feb 22, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1962477836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK STREET",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9146",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 W NORTH AVE",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054436",
            "telephone_number": "262-784-3800",
            "fax_number": "262-784-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKATA",
        "first_name": "MARIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "31851020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Marie.Nakata@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "17100 W North Ave",
            "address_2": "Suite 200",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530054436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea L. Munoz, M.D.
• Sheila Murphy, RN CDE
• Amanda Rose Nachtwey Fritsch, COTA
• Armona Rose Nadler-Strick, AUD
• Brittany Naida
• Steven K Nakata, MD
• Aruna Nammi, M.D
• Thim P Nanda, MD
• Usha Nanda, M.D
• National Pedorthic Services, Inc.

• Dermatology Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.