| Sujan Fernando, | |
|
9200 W Wisconsin Ave, Department Of Radiology, Milwaukee, WI 53226-3522 | |
| (414) 805-3750 | |
| (414) 259-9290 |
| Full Name | Sujan Fernando |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 17 Years |
| Location | 9200 W Wisconsin Ave, Milwaukee, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023272200 | NPI | - | NPPES |
| 008911900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | ME115385 (Florida) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 54297 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Froedtert Memorial Lutheran Hospital | Milwaukee, WI | Hospital |
| Community Memorial Hospital | Menomonee falls, WI | Hospital |
| St Josephs Community Hospital West Bend | West bend, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Medical College Of Wisconsin Inc | 2668384371 | 1902 |
| Froedtert Andthe Medical College Of Wisconsin Community Physicians Inc | 3678760063 | 1105 |
| Memorial Mri And Diagnostic Llc | 6507859568 | 56 |
| Entity Name | The Medical College Of Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699720086 PECOS PAC ID: 2668384371 Enrollment ID: O20031120000259 |
| Entity Name | Froedtert &the Medical College Of Wisconsin Community Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568787448 PECOS PAC ID: 3678760063 Enrollment ID: O20101210000699 |
| Entity Name | Froedtert Manitowoc Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437829975 PECOS PAC ID: 2365836954 Enrollment ID: O20220224001282 |
| Mailing Address | Practice Location Address |
|---|---|
| Sujan Fernando, 9200 W Wisconsin Ave, Department Of Radiology, Milwaukee, WI 53226-3522 Ph: (414) 805-3750 | Sujan Fernando, 9200 W Wisconsin Ave, Department Of Radiology, Milwaukee, WI 53226-3522 Ph: (414) 805-3750 |
Dr. Hong Chen, MD Radiology Medicare: Medicare Enrolled Practice Location: 9200 W Wisconsin Ave, Department Of Radiology, Milwaukee, WI 53226 Phone: 414-805-3700 Fax: 414-805-3777 | |
Dr. Alessandro Vidoni, Radiology Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-805-2060 | |
Dr. Zacharias P Zitterkopf, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2900 W Oklahoma Ave, Milwaukee, WI 53215 Phone: 414-649-6000 Fax: 414-649-5296 | |
Javier Alberto Lopez Puebla, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 9200 W. Wisconsin Ave, Hub Radiology 3740-4, Milwaukee, WI 53226 Phone: 414-955-1195 Fax: 414-259-9290 | |
James Benjamin Moroney, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 8701 W Watertown Plank Rd, Milwaukee, WI 53226 Phone: 414-456-6800 | |
Allan Vannostrand, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 945 N 12th St, Ste E360, Milwaukee, WI 53233 Phone: 414-219-7226 |