NPI Registry.org

Roya Gandt

NPI Registration Record

Provider / OrganizationNPIDate Certified
ROYA GANDT10236659242024-04-05

Roya Gandt is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1023665924. Registration indicates Roya Gandt is a provider of access to pediatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Neonatal, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Neonatal, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )

RegistrationPART-B:Y
DME:Y
HHA:Y
PMD:Y
Entity TypeIndividual
Provider Name Roya Gandt NNP-BC
Other Provider Name Roya Shahegh
Practice Office Address9000 W WISCONSIN AVE
MILWAUKEE, WI US
Practice Office Telephone4142666820
Practice Office Fax4142666979
Mailing Address9000 W WISCONSIN AVE
MILWAUKEE, WI 532264874 US
Business Telephone4142666820
Business Fax4142666979
Offices / Locations
AddressCity / StatePhone / Fax
8915 W Connell Ave Wauwatosa, WI 532263067 4142662000
9200 W Wisconsin Ave Milwaukee, WI 532263522 4148056600 / 4148056622
3200 Pleasant Valley Rd West Bend, WI 530959274 2628367300 / 2628367301
W180N8085 Town Hall Rd Menomonee Falls, WI 530513518 2622575000 / 2625185052
HPT Codes
CodePractice
License No
State
363LN0000X PRIMARYAccess to Pediatric Primary Care Providers
Physician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Physician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Nurse Practitioner: Neonatal

All Other Specialties & Provider Types

Nurse Practitioner Neonatal
Physician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
9593
WI
OPI Codes
1023665924 MEDICAID WI
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