AYKARETHU O MAMMEN (NPI# 1417993791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417993791 |
| Entity Type | Individual |
| Full Name | AYKARETHU O MAMMEN |
| Credential | MD |
| Practice Address |
4922 Columbia Rd Cedarburg WI 53012-9188 |
| Practice Telephone | 2623752829 |
| Practice Fax Number | 2623758513 |
| Mailing Telephone | 2623752829 |
| Mailing Fax Number | 2623758513 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 20052 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31155700 | 05 |
| Street Address |
4922 COLUMBIA RD |
| City | CEDARBURG |
| State | WI |
| Zip Code | 53012-9188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073500393 | Health and Rehabilitation Consultants, Inc. | Physical Therapist | 4922 Columbia Rd, Cedarburg, WI 53012-9188 | 2005-10-03 |
| 1912277906 | Thomas J Shewczyk Md Sc | Clinic/Center | 4922 Columbia Rd, Suite 100, Cedarburg, WI 53012-9188 | 2012-01-06 |
| 1285823161 | Ann V. John | Occupational Therapist | 4922 Columbia Rd, Cedarburg, WI 53012-9188 | 2007-10-17 |
| 1952515272 | Donald L. Olsen | Physical Therapist | 4922 Columbia Rd, Cedarburg, WI 53012-9188 | 2007-05-09 |
| 1427094796 | Indira Mammen | Obstetrics & Gynecology | 4922 Columbia Rd, Cedarburg, WI 53012-9188 | 2006-06-22 |
| 1316997034 | Julie Chicks, M.d., S.c. | Internal Medicine | 4922 Columbia Rd, Cedarburg, WI 53012-9188 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639565351 | Angela Marie Phillips | Counselor | 8750 Western Rd, Cedarburg, WI 53012 | 2015-04-09 |
| 1922403641 | Nickolas Wimble | Hearing Instrument Specialist | W62n244 Washinton St, #104, Cedarburg, WI 53012 | 2014-10-23 |
| 1285902429 | Mary B Pistiner | Pharmacist | W62 N190 Washington Ave, Walgreens, Cedarburg, WI 53012 | 2011-12-02 |
| 1285931360 | Accuquest Hearing Centers | Clinic/Center | N54w65 Mill Street, Ste 800, Cedarburg, WI 53012 | 2011-02-25 |
| 1417283532 | Laura Egan Cutler | Speech-Language Pathologist | N87 W6334 Brookdale Dr, Cedarburg, WI 53012 | 2009-10-23 |
| 1790945053 | Diane M Kerkman | Licensed Practical Nurse | W63 N14264 Washington Ave #13, Cedarburg, WI 53012 | 2008-06-11 |
| 1346416856 | Robert H Schwengel | Dentist | W62n179 Washington Ave, Cedarburg, WI 53012 | 2008-05-05 |
| 1174710479 | Assisted Living Concepts Inc | Assisted Living Facility | W56 N225 Mckinley Blvd, Cedarburg, WI 53012 | 2007-10-01 |
| 1699968016 | Jay Timothy Brogelman | Occupational Therapy Assistant | N27 W5707 Lincoln Blvd., Cedar Springs Health and Rehabilitation Center, Cedarburg, WI 53012 | 2007-08-20 |
| 1053517722 | Bruce J Stevens | Dentist | N52 W6295 Mill Street, Cedarburg, WI 53012 | 2007-06-21 |
| Find all providers in zip 53012 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 |
|---|---|---|---|---|
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861969149 | Watertown Physician Practices LLC | Surgery | 123 Hospital Dr Ste 2009, Watertown, WI 53098-3320 | 2018-10-25 |
| 1356847644 | Laura K Krecko | Surgery | Uw Hospital and Clinics 600 Highland Avenue, Madison, WI 53792-0001 | 2018-04-04 |
| 1447785332 | Patrick Beard Schwartz | Surgery | Uw Hopsitals and Clinics, 600 Highland Ave., Madison, WI 53792-0001 | 2017-04-27 |
| 1700263720 | Marianna Dubovska | Surgery | 902 Riverside Dr Ste 201, Waupaca, WI 54981-1992 | 2015-04-28 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1972901262 | The Healthy Vein, Sc | Surgery | N79w14684 Appleton Ave, Menomonee Falls, WI 53051-4308 | 2014-12-18 |
| 1326453200 | Chey V Collura | Surgery | 2700 W 9th Ave Ste 310, Oshkosh, WI 54904 | 2014-06-30 |
| 1538570338 | Nicholas Sich | Surgery | 2901 W Kinnickinnic River Pkwy Dept Ste 540, Milwaukee, WI 53215-3677 | 2014-05-14 |
| Find all providers with the same taxonomy | ||||
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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.