Individual provider Active NPI

Nicholas Tadeo, M.D.

  • Diagnostic Radiology Physician
  • Milwaukee, WI
National Provider Identifier
1992192256
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
66569-20 Issued in WI
Practice address
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone
(414) 649-6000
NPI assigned
Apr 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 66569-20 WI Primary

Addresses

Primary practice location

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 649-6000

Other practice location 1

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-3666

Other practice location 2

4455 S 108th St
Greenfield, WI 53228-2504
Phone (414) 427-5310

Other practice location 3

2445 N Mayfair Rd
Wauwatosa, WI 53226-1401
Phone (414) 774-7226

Other practice location 4

W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 257-3060

Other practice location 5

1905 N Calhoun Rd
Brookfield, WI 53005-5036
Phone (262) 754-8000

Other identifiers 2

IdentifierTypeStateIssuer
1992192256MedicaidWI
100098153MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ntadeo92341@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20200414002564 WI Practitioner - Diagnostic Radiology 2769812841 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66569-20WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jul 19, 2021 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Aurora Medical Group, Inc. Diagnostic Radiology Current Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jul 19, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 19, 2021 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Apr 14, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Apr 14, 2020 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jul 19, 2021 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jul 19, 2021 Accepting new patients

Locations

1905 N Calhoun Rd
Brookfield, WI 53005
Phone (262) 333-0040

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

4455 S 108th St
Milwaukee, WI 53228
Phone (414) 409-7593

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

5818 W Capitol Dr
Milwaukee, WI 53216
Phone (414) 447-8071

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

2445 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 774-7226

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • Direct secure messaging: ntadeo92341@direct.myadvocateaurora.org

Organizations & group practices 9

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1992192256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-649-6000",
            "fax_number": "414-649-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-649-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-3666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4455 S 108th St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532282504",
            "country_code": "US",
            "telephone_number": "414-427-5310",
            "fax_number": "414-427-5311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2445 N Mayfair Rd",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532261401",
            "country_code": "US",
            "telephone_number": "414-774-7226",
            "fax_number": "414-454-4995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W180N8085 Town Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-257-3060",
            "fax_number": "262-518-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1905 N Calhoun Rd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055036",
            "country_code": "US",
            "telephone_number": "262-754-8000",
            "fax_number": "262-780-3396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TADEO",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "66569-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992192256",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098153",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntadeo92341@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "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": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.