DR. JUANILITO N SELDERA (NPI# 1750498945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750498945 |
| Entity Type | Individual |
| Full Name | DR. JUANILITO N SELDERA |
| Credential | MD |
| Practice Address |
N2950 State Road 67 Lake Geneva WI 53147-2655 |
| Practice Telephone | 2622454990 |
| Practice Fax Number | 2622452248 |
| Mailing Telephone | 2622454990 |
| Mailing Fax Number | 2622452248 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2015-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 23586-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036061793 2 | 05 | |
| WI | 1750498956 | 05 | |
| DEA NUMBER | AS9711246 | 01 | |
| WI | MERCYCARE INSURANCE | SELDEJUA | 01 |
| WI | BCBSWI | 1750498945 | 01 |
| WI | 30372400 | 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 |
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| 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 | 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 |
|---|---|---|---|---|
| 1386969400 | Emily Kathleen Wilczak | Surgery | N2950 Wi-67, Lake Geneva, WI 53147 | 2010-03-31 |
| 1780791012 | Dmitry K Pasikhov | Surgery | 146 E Geneva Square, Lake Geneva, WI 53147 | 2006-08-23 |
| 1164412136 | James J Greenberg | Surgery | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2005-10-21 |
| 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 |
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| 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.