| Tracy Renee Geoffrion, MD | |
| 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | |
| (414) 266-2380 | |
| (414) 266-2294 | 
| Full Name | Tracy Renee Geoffrion | 
|---|---|
| Gender | Female | 
| Speciality | Surgery | 
| Location | 9000 W Wisconsin Ave, Milwaukee, Wisconsin | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1760748107 | NPI | - | NPPES | 
| 1760748107 | Medicaid | WI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 22963 (Wisconsin) | Secondary | 
| 208600000X | Surgery | 2025-00179 (North Carolina) | Primary | 
| 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 | Childrens Specialty Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1942970405 PECOS PAC ID: 2567813447 Enrollment ID: O20240104002075 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Tracy Renee Geoffrion, MD 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 Ph: (414) 266-2380 | Tracy Renee Geoffrion, MD 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 Ph: (414) 266-2380 | 
| Jiro Kimura,  Surgery Medicare: Medicare Enrolled Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-805-6400 Fax: 414-955-0213 | |
| Dr. David L Larson, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 8700 Watertown Plank Road, Wisconsin Athletic Club Bldg, Milwaukee, WI 53226 Phone: 414-805-3666 | |
| Dr. John J Aiken, MD Surgery Medicare: Medicare Enrolled Practice Location: 9000 W Wisconsin Ave, Pediatric Surgery, Milwaukee, WI 53226 Phone: 414-266-6550 Fax: 414-266-6579 | |
| Jeffrey Anderson, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 215-707-3133 | |
| Dr. Jeremy Holzmacher Levin, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-955-1700 Fax: 414-955-0072 | |
| Dr. Keith T Oldham, MD Surgery Medicare: Medicare Enrolled Practice Location: 9000 W Wisconsin Ave, Pediatric Surgery, Milwaukee, WI 53226 Phone: 414-266-6550 Fax: 414-266-6579 | |
| William R Deshur, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2801 W Kk River Pkwy, Suite 330, Milwaukee, WI 53215 Phone: 414-649-3240 Fax: 414-649-3244 |