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SOUTHEASTERN PEDIATRICS, SC
NPI 1154765410
Family Medicine in Wauwatosa, WI

Active since April 17, 2013
10625 W NORTH AVE STE 326, WAUWATOSA, WI 53226(414) 771-0500(414) 771-0363 Get Directions Write a Review

NPPES record last updated: May 15, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 15, 2024, May 11, 2024, May 19, 2022 and 1 more (4 updates tracked since 2017).

About Southeastern Pediatrics, Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN PEDIATRICS, SC (NPI 1154765410) is a healthcare organization registered as a family medicine in Wauwatosa, Wisconsin and active in the NPI registry since April 2013. The organization lists Ratidzai Rioga, President, as its authorized official.

NPPES Registry Identity

NPI1154765410
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHEASTERN PEDIATRICS, SC
Location Address10625 W NORTH AVE STE 326Wauwatosa, WI 53226-2315
Mailing Address7592 Solutions Ctr # 777592Chicago, IL 60677-7005 · (262) 641-3700 · Fax (262) 641-3719
Phone(414) 771-0500
Fax(414) 771-0363
Organization SubpartNo
Authorized OfficialRatidzai RiogaPresident · (414) 771-0500
Enumeration DateApril 17, 2013
Last NPPES UpdateMay 15, 20244 updates tracked since enumeration
NPPES CertifiedMay 15, 2024
✔ NPI 1154765410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 41265
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPediatrics · Adolescent MedicineTaxonomy 2080A0000X · License 41265 (WI)
10625 W NORTH AVE STE 326, Wauwatosa, WI 53226
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southeastern Pediatrics, Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southeastern Pediatrics, Sc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ratidzai Rioga, MD
Pediatric Medicine
NPI 1437215001
10625 W NORTH AVE STE 326
Wauwatosa, WI 53226
(414) 771-0500
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeastern Pediatrics, Sc's NPI number?

The NPI number for Southeastern Pediatrics, Sc is 1154765410. It was assigned to this organization in the NPPES registry on April 17, 2013.

Where is Southeastern Pediatrics, Sc located?

Southeastern Pediatrics, Sc is located at 10625 W North Ave Ste 326, Wauwatosa, WI 53226. The listed phone number is (414) 771-0500.

What is Southeastern Pediatrics, Sc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Southeastern Pediatrics, Sc enrolled in Medicare?

Yes. Southeastern Pediatrics, Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southeastern Pediatrics, Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pediatric Medicine) reassigns their Medicare billing to Southeastern Pediatrics, Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southeastern Pediatrics, Sc accept?

Health plans from Anthem Blue Cross and Blue Shield list Southeastern Pediatrics, Sc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeastern Pediatrics, Sc was last updated on May 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.