SUPATRA A AGARWAL (NPI# 1033589635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033589635 |
| Entity Type | Individual |
| Full Name | SUPATRA A AGARWAL |
| Other Name | SUPATRA A CHANTACHOTE |
| Credential | AA |
| Practice Address |
9200 W Wisconsin Avenue Department of Anesthesiology Milwaukee WI 53226-3522 |
| Practice Telephone | (414) 805-8700 |
| Practice Fax Number | 4142591522 |
| Mailing Telephone | (414) 805-8700 |
| Mailing Fax Number | 4142591522 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2017-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | 95 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 015797000 | 05 |
| Street Address |
9200 W WISCONSIN AVENUE DEPARTMENT OF ANESTHESIOLOGY |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588655781 | Marc A Demoya | Surgery | 9200 W Wisconsin Avenue, Trauma Surgery, Milwaukee, WI 53226-3522 | 2005-11-04 |
| 1710531397 | Jessica Rose Gaddy | Nurse Practitioner | 9200 W Wisconsin Avenue, Milwaukee, WI 53226-3522 | 2019-07-31 |
| 1285163931 | Rachel Nordstrom | Emergency Medicine | 9200 W Wisconsin Avenue, 1p, Milwaukee, WI 53226 | 2017-06-07 |
| 1861856734 | Yiwen Cui | Obstetrics & Gynecology | 9200 W Wisconsin Avenue, Department of Obstetrics and Gynecology, Milwaukee, WI 53226-3522 | 2016-04-07 |
| 1386012060 | Megan Neperud | Physician Assistant | 9200 W Wisconsin Avenue, Milwaukee, WI 53226-3522 | 2015-09-11 |
| 1659758050 | Ariel Kleman | Internal Medicine | 9200 W Wisconsin Avenue, Milwaukee, WI 53207-2141 | 2015-05-05 |
| 1912317983 | Adam Levin | Internal Medicine | 9200 W Wisconsin Avenue, Department of Internal Medicine, Milwaukee, WI 53226-3522 | 2014-04-30 |
| 1801216478 | Chad Wenzel | Internal Medicine | 9200 W Wisconsin Avenue, Dept of Internal Medicine, Milwaukee, WI 53226-3522 | 2014-04-22 |
| 1376961870 | Brian William Quinn | Internal Medicine | 9200 W Wisconsin Avenue, Department of Internal Medicine, Milwaukee, WI 53226-3522 | 2014-04-01 |
| 1942628706 | Sara Michelle Koller Dunbar | Internal Medicine | 9200 W Wisconsin Avenue, Dept of Internal Medicine, Milwaukee, WI 53226-3522 | 2014-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831705664 | Fauzan Ali | Anesthesiologist Assistant | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-09-17 |
| 1659991891 | Isaac Alghoosen | Anesthesiologist Assistant | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-04-17 |
| 1073132437 | Brett P Siemon | Anesthesiologist Assistant | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-04-15 |
| 1972122448 | Mallory A Mews | Anesthesiologist Assistant | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-04-14 |
| 1568090504 | Nechemiah Leib Kushner | Anesthesiologist Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-03-27 |
| 1205467354 | Steven Erich Kenneth Pollack | Anesthesiologist Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-01-28 |
| 1164052940 | Kelsey Jean Pohlmann | Anesthesiologist Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-01-22 |
| 1790315570 | Austin Robert Chriske | Anesthesiologist Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-01-22 |
| 1568002848 | Jonathan London | Anesthesiologist Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-01-14 |
| 1023658549 | Lea Van Heule | Anesthesiologist Assistant | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-01-13 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.