Individual provider Active NPI

Neda Naderi

  • Internal Medicine Physician
  • Kenosha, WI
National Provider Identifier
1992360804
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
81033 Issued in WI
Practice address
3400 Market LN
Kenosha, WI 53144-3430
Phone
(262) 551-4600
Fax
(262) 551-4635
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 81033 WI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3400 Market LN
Kenosha, WI 53144-3430

Mailing address

3400 Market LN
Kenosha, WI 53144-3430
Phone (262) 551-4600

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
I20230425000210 WI Practitioner - Internal Medicine 0547592404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Nova Southeastern College of Osteo Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

3400 Market LN
Kenosha, WI 53144-3430
Phone (262) 551-4600

Hospital & facility affiliations

  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. CurrentSince Apr 3, 2023 Accepting new patients
Froedtert South, Inc. Past Accepting new patients

Locations

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

3400 Market Ln
#200
Kenosha, WI 53144

3400 Market Ln
Ste 200
Kenosha, WI 53144
Phone (262) 551-4600

3400 Market Ln
Kenosha, WI 53144
Phone (262) 551-4600

3400 Market Ln
Fl 2
Kenosha, WI 53144

Interoperability endpoints

  • Direct secure messaging: nnaderi634698@direct.froedtert.com

Organizations & group practices 2

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 1

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": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1992360804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 MARKET LN",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531443430",
            "telephone_number": "262-551-4600",
            "fax_number": "262-551-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MARKET LN",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531443430",
            "telephone_number": "262-551-4600",
            "fax_number": "262-551-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADERI",
        "first_name": "NEDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "81033",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.