DR. BRADLEY M FIDELER (NPI# 1629153077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629153077 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY M FIDELER |
| Credential | MD |
| Practice Address |
N2950 State Road 67 Lake Geneva WI 53147-2655 |
| Practice Telephone | 2622450535 |
| Mailing Telephone | 2622450535 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
36125 | WI | Allopathic & Osteopathic Physicians |
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32141800 | 05 |
| Street Address |
N2950 STATE ROAD 67 |
| City | LAKE GENEVA |
| State | WI |
| Zip Code | 53147-2655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386631281 | Shweta Pearlstein | Anesthesiology | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2005-10-05 |
| 1154928547 | Jessica M Grubb | Occupational Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2020-10-08 |
| 1063072650 | Madalyn R Douglas | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2019-06-17 |
| 1013421908 | Ashley E. Boro | Occupational Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-11-30 |
| 1447776950 | Stefanie N Droese | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-16 |
| 1427573773 | Andrea M. Lysaght | Registered Nurse | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-08 |
| 1265956288 | Kyle C. Janicke | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-01 |
| 1164952891 | Carling M. Johns | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-06-15 |
| 1730615030 | Deborah Lynn Young | Registered Nurse | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-05-04 |
| 1386180255 | Shelly M Weis | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951206 | Emily Tanis | Physical Therapist | 6722 Wi-50, Lake Geneva, WI 53147 | 2020-08-05 |
| 1588295653 | Baylee M Noe | Occupational Therapy Assistant | Sage Meadow of Lake Geneva 6722 Wi-50, Lake Geneva, WI 53147 | 2020-01-28 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1386969400 | Emily Kathleen Wilczak | Surgery | N2950 Wi-67, Lake Geneva, WI 53147 | 2010-03-31 |
| 1538294020 | Dale Alan Miller | Pharmacist | 2950 St. Hwy. 67, Lake Geneva, WI 53147 | 2007-02-23 |
| 1689779902 | Balistreri & Associates Physical Therapy | Physical Therapist | 902 Wells Street, Lake Geneva, WI 53147 | 2006-09-13 |
| 1336157981 | Nestor C Alabarca | Internal Medicine | 146 E Geneva Square, Lake Geneva, WI 53147 | 2006-08-03 |
| 1144259375 | Kim M. Cuculi | Occupational Therapist | 800 Geneva Pkwy N Ste 3, Lake Geneva, WI 53147 | 2006-07-01 |
| 1396253571 | Amar Y. Patel | Family Medicine | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2018-01-22 |
| 1679017925 | Christina L. Clancy | Nurse Practitioner | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2016-12-06 |
| Find all providers in zip 53147 | ||||
| Taxonomy Code | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013938463 | James L Knavel | Orthopaedic Surgery | 352 Peller Rd, Lake Geneva, WI 53147-4543 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902850696 | Bone & Joint Clinic S.c. | Orthopaedic Surgery | 225000 Hummingbird Rd, Ste 100, Wausau, WI 54401-6312 | 2006-05-19 |
| 1053310474 | David James Siverhus | Orthopaedic Surgery | 2500 N Mayfair Rd, Suite 670, Milwaukee, WI 53226-1409 | 2005-07-18 |
| 1922453398 | Orthopaedic Centers of Wisconsin S.c. | Orthopaedic Surgery | 3200 Westhill Dr, Suite 201, Wausau, WI 54401-4705 | 2016-05-04 |
| 1174977433 | Orthopaedic Centers of Wisconsin, S.c. | Orthopaedic Surgery | 3200 Westhill Dr Ste 201, Wausau, WI 54401-4707 | 2016-04-22 |
| 1427476969 | Michael Derek Vaughn | Orthopaedic Surgery | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2014-04-02 |
| 1104262682 | Jasmine Bauknight | Orthopaedic Surgery | 1715 Dousman St, Green Bay, WI 54303-3211 | 2013-05-10 |
| 1154664100 | Dayton M Opel | Orthopaedic Surgery | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2013-03-28 |
| 1194088567 | Kristin Tompkins Mizerik | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2012-06-20 |
| 1881919892 | David William Meister | Orthopaedic Surgery | 525 W River Woods Pkwy, Suite 230, Glendale, WI 53212-1024 | 2010-04-01 |
| 1013173384 | Scott Remo Murch | Orthopaedic Surgery | 3200 Westhill Dr, Suite 201, Wausau, WI 54401-4705 | 2008-08-05 |
| Find all providers with the same taxonomy | ||||
| City | LAKE GENEVA |
| Zip Code | 53147 |
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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.