NPIMap

Organization Active NPI

Bayview Dermatology & Cosmetic Surgery SC

  • Dermatology Physician
  • Bayview, WI
National Provider Identifier
1992713929
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BAYVIEW DERMATOLOGY & COSMETIC SURGERY SC
Practice address
3119 W Clement Ave
Suite 100
Bayview, WI 53207
Phone
(414) 769-0040
Fax
(414) 769-0048
NPI assigned
Aug 4, 2006
Last updated
Mar 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Neal N Bhatia, MD
Title
President Owner
Phone
(414) 769-0040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

3119 W Clement Ave
Suite 100
Bayview, WI 53207

Mailing address

4555 West Schroeder Drive
Suite 170
Milwaukee, WI 53223
Phone (414) 365-3210

Other identifiers 1

IdentifierTypeStateIssuer
34443900MedicaidWI

National Provider Directory

National Provider Directory

Locations

3119 S Clement Ave
#100
Milwaukee, WI 53207
Phone (414) 769-0040

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1992713929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 WEST SCHROEDER DRIVE",
            "address_2": "SUITE 170",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53223",
            "telephone_number": "414-365-3210",
            "fax_number": "414-365-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3119 W CLEMENT AVE",
            "address_2": "SUITE 100",
            "city": "BAYVIEW",
            "state": "WI",
            "postal_code": "53207",
            "telephone_number": "414-769-0040",
            "fax_number": "414-769-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYVIEW DERMATOLOGY & COSMETIC SURGERY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "BHATIA",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "414-769-0040",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34443900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayview, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.