MEDICARE: DR. LISA ANN BARATTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	30716-020	WI
2	207UN0901X	Nuclear Cardiology Physician	30716	WI
3	207RC0000X	Cardiovascular Disease Physician	30716	WI
4	207R00000X	Internal Medicine Physician	30716	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356340285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA ANN BARATTA MD

Provider Business Mailing Address
First Line	:	19725 DAVIDSON RD
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045
Country	:	US
Telephone Number	:	262-389-1202
Fax Number	:	414-649-3551

Provider Business Practice Location Address
First Line	:	19725 DAVIDSON RD
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045
Country	:	US
Telephone Number	:	262-389-1202
Fax Number	:	414-649-3551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	08/08/2024

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