Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ezra Teitelbaum, MD

Individual provider Surgery Physician · NPI 1104052521

Ezra Teitelbaum, MD is a General Surgery in Milwaukee, Wisconsin. Graduated from Icahn School of Medicine at Mount Sinai in 2008, 18 years ago. Practices with The Medical College of Wisconsin Inc, a 2,093-clinician group, accepts Medicare assignment and offers telehealth. Licensed in District of Columbia and Wisconsin.

Years since qualifying
18
Trained at
Icahn School of Medicine at Mount Sinai
Licensed in
DC, WI
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9200 W Wisconsin Ave Dept OF
Milwaukee, WI 53226-3522
Phone: (414) 955-7113
Fax: (414) 805-8097
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 85642 (WI)
Surgery Physician Taxonomy 208600000X · Licence 148293 (DC)

Record details

NPI number1104052521
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 1, 2009
Last updated in NPPESApril 16, 2025
Certification dateApril 16, 2025
Mailing address9200 W Wisconsin Ave Dept Of, Milwaukee, WI 53226-3522

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Graduated 2008 (18 years in practice)
Group practice The Medical College Of Wisconsin Inc — 2093 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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