HIGHLANDER DERMATOLOGY LLC NPI 1790216554

NPI Information

  • NPI: 1790216554
  • Provider Name: HIGHLANDER DERMATOLOGY LLC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • CLIA Number: 52D2135992
  • Address: 16650 W BLUEMOUND RD STE 600
    BROOKFIELD, WI
    ZIP 53005
  • Phone: (262) 290-4540

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NPI Details

HIGHLANDER DERMATOLOGY LLC is a medical specialty clinic center in Brookfield, WI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). HIGHLANDER DERMATOLOGY LLC NPI is 1790216554. The provider is registered as an organization entity type.

The provider's business location address is:

16650 W BLUEMOUND RD STE 600
BROOKFIELD, WI
ZIP 53005-970
Phone: (262) 290-4540
Fax: (262) 299-6435

The provider's authorized official is Bradley T.j. Straka .
The authorized official title is Owner and has the following contact phone number (414) 899-2385.

The CLIA number assigned to this NPI record is 52D2135992 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/23/2017 and was last updated on 8/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical SpecialtyH059290WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11518950153MEDICAIDWISCONSIN
21215992979OTHERWISCONSINNPI
31326031964OTHERWISCONSINSOLE OWNER NPI: 1326031964. HIGHLANDER LLC TIN:
41912942285MEDICAIDWISCONSIN
51518950153OTHERWISCONSINNPI
61912942285OTHERWISCONSINNPI
71215992979MEDICAIDWISCONSIN
81346499738OTHERWISCONSINNPI
91326031964MEDICAIDWISCONSIN
101346499738MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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