SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE – NPI #1457483612
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE is a provider located in MILWAUKEE, WI. NPPES has assigned the NPI number 1457483612 to SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE on March 12, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE” is a dba name, the actual legal business name for this organization is SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE, S.C.. The primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics.

The NPI profile was previously updated about 11 years ago on Apr 30, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE below.

NPI Profile for
SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE, S.C.

NPI Number
1457483612
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE, S.C.
Doing Business As (dba): SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE
Primary location
8532 W CAPITOL DR
MILWAUKEE, WI 53222-1848
Phone: (414) 463-2607 Fax: (414) 463-6743
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
ROSIE DELTORO
ASSISTANT OFFICE MANAGER
Phone: (414) 463-2607
Updated
Identifiers

Identifiers for SOUTHEASTERN PEDIATRIC & ADOLESCENT MEDICINE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI32787700
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208000000X
- Pediatrics (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.