CARDIOTHORACIC SURGERY GROUP SC (NPI# 1053388553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053388553 |
| Entity Type | Organization |
| Organization Name | CARDIOTHORACIC SURGERY GROUP SC |
| Practice Address |
2315 N Lake Dr Milwaukee WI 53211-4516 |
| Practice Telephone | 4142715119 |
| Practice Fax Number | 4142713756 |
| Mailing Telephone | 4142715119 |
| Mailing Fax Number | 4142713756 |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT P MCMANUS (PRESIDENT) |
| Authorized Official Telephone | 4142715119 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32895200 | 05 |
| Street Address |
2315 N LAKE DR |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912990466 | Evonne Marie Winston | Dermatology | 2315 N Lake Dr, Suite 701, Milwaukee, WI 53211-4518 | 2005-08-30 |
| 1558557504 | Donna Mae Mullen | Audiologist-Hearing Aid Fitter | 2315 N Lake Dr, Suite 1005, Milwaukee, WI 53211-4518 | 2007-09-23 |
| 1114139409 | Keirsen Muffler | Audiologist | 2315 N Lake Dr, Suite 1005, Milwaukee, WI 53211-4518 | 2007-05-07 |
| 1700908902 | Lynn A Vice Psyd Sc | Psychologist | 2315 N Lake Dr, Milwaukee, WI 53211-4518 | 2007-04-06 |
| 1205965761 | Herslof's, Inc | Technician/Technologist | 2315 N Lake Dr, Milwaukee, WI 53211-4518 | 2007-03-02 |
| 1417086901 | Paul R Herzfeld | Optometrist | 2315 N Lake Dr, Milwaukee, WI 53211-4518 | 2007-03-02 |
| 1295876068 | Harry A. Easom | Specialist | 2315 N Lake Dr, #617, Milwaukee, WI 53211-4518 | 2007-02-12 |
| 1407994700 | Lynn A. Vice, Psy.d., S. C. | Psychologist | 2315 N Lake Dr, Suite 820, Milwaukee, WI 53211-4518 | 2007-02-01 |
| 1669518916 | Reproductive Specialty Center | Specialist | 2315 N Lake Dr, Suite 501, Milwaukee, WI 53211-4518 | 2007-01-30 |
| 1689733834 | Stephen Pallen | Spec/Tech, Cardiovascular | 2315 N Lake Dr, Suite 703, Milwaukee, WI 53211-4518 | 2006-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
| Find all providers in zip 53211 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932308186 | Great Lakes Medical & Surgical Center | Surgery | 6000 South 27th Street, Milwaukee, WI 53221 | 2007-07-17 |
| 1821352683 | Neel Anand Mansukhani | Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2012-06-26 |
| 1770731077 | Rajeev Gupta | Surgery | 2801 W Kinnickinnic River Pkwy Ste 330, Milwaukee, WI 53215-3678 | 2008-08-29 |
| 1639353204 | Anilkumar Singh Md Sc | Surgery | 2745 W Layton Ave, Suite 202, Milwaukee, WI 53221-2651 | 2007-12-19 |
| 1912045097 | Patricia E Burrows | Surgery | 9000 W Wisconsin Ave, Ms 721, Milwaukee, WI 53226-4874 | 2007-02-02 |
| 1285727453 | John Wilson Bowman | Surgery | 11414 W Park Pl, Ste 300, Milwaukee, WI 53224-3500 | 2006-10-02 |
| 1629006887 | Joseph Patrick Hart | Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2006-06-28 |
| 1154375400 | Kellie R Brown | Surgery | 9200 W Wisconsin Ave, Division of Vascular Surgery, Milwaukee, WI 53226-3522 | 2006-05-20 |
| 1205888948 | Brian D Lewis | Surgery | 9200 W Wisconsin Ave, Vascular Surgery, Milwaukee, WI 53226-3522 | 2006-05-17 |
| 1407809148 | Gary Seabrook | Surgery | 9200 W Wisconsin Ave, Vascular Surgery, Milwaukee, WI 53226-3522 | 2006-05-17 |
| 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.