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ALLEGIANCE INTERNAL MEDICINE SPECIALISTS, SC
NPI 1699808196
Internal Medicine in Wauwatosa, WI

Active since March 13, 2007CLIA 52D1063950 · Waiver
2645 N MAYFAIR RD STE 200, WAUWATOSA, WI 53226(414) 479-1800(414) 479-1813 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Allegiance Internal Medicine Specialists, Sc NPPES

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

ALLEGIANCE INTERNAL MEDICINE SPECIALISTS, SC (NPI 1699808196) is a healthcare organization registered as an internal medicine in Wauwatosa, Wisconsin and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through January 24, 2027 and lists Andrew C Kim, President, as its authorized official.

NPPES Registry Identity

NPI1699808196
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameALLEGIANCE INTERNAL MEDICINE SPECIALISTS, SC
Location Address2645 N MAYFAIR RD STE 200Wauwatosa, WI 53226-1304
Mailing Address2645 N Mayfair Rd Ste 200Wauwatosa, WI 53226-1304 · (414) 479-1800 · Fax (414) 479-1813
Phone(414) 479-1800
Fax(414) 479-1813
Organization SubpartNo
Authorized OfficialAndrew C KimPresident · (414) 479-1800
Enumeration DateMarch 13, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1699808196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2645 N MAYFAIR RD STE 200, 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)

Allegiance Internal Medicine Specialists, Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Allegiance Internal Medicine Specialists, Sc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Andrew Kim, MD
Internal Medicine
NPI 1184697625
2645 N MAYFAIR RD #200
Wauwatosa, WI 53226
(414) 479-1800
✔ PECOSSame address
Samuel Idarraga, M.D.
Internal Medicine
NPI 1700850070
2645 N MAYFAIR RD SUITE 200
Wauwatosa, WI 53226
(414) 479-1800
✔ PECOSSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D1063950

Allegiance Internal Medicine Specialists Sc · Wauwatosa, WI
Active · expires Jan 24, 2027
CLIA Number52D1063950
Laboratory TypePhysician Office
Certificate Effective DateJanuary 25, 2025
Certificate Expiration DateJanuary 24, 2027
Laboratory DirectorAndrew C. Kim, MD
Laboratory Phone(414) 479-1800
Laboratory LocationAllegiance Internal Medicine Specialists Sc2645 N Mayfair Rd Suite 200, Wauwatosa, WI 53226
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Allegiance Internal Medicine Specialists, Sc's NPI number?

The NPI number for Allegiance Internal Medicine Specialists, Sc is 1699808196. It was assigned to this organization in the NPPES registry on March 13, 2007.

Where is Allegiance Internal Medicine Specialists, Sc located?

Allegiance Internal Medicine Specialists, Sc is located at 2645 N Mayfair Rd Ste 200, Wauwatosa, WI 53226. The listed phone number is (414) 479-1800.

What is Allegiance Internal Medicine Specialists, Sc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Allegiance Internal Medicine Specialists, Sc enrolled in Medicare?

Yes. Allegiance Internal Medicine Specialists, Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Allegiance Internal Medicine Specialists, Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Allegiance Internal Medicine Specialists, 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Allegiance Internal Medicine Specialists, Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D1063950) is associated with this NPI, valid through January 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Allegiance Internal Medicine Specialists, Sc accept?

Health plans from Anthem Blue Cross and Blue Shield list Allegiance Internal Medicine Specialists, 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 Allegiance Internal Medicine Specialists, Sc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.