{"npi":"1912149170","type":"NPI-1","status":"active","name":{"display":"Dr. Kristen Klement Tassone M.D.","other":[{"code":"1","type":"Formerly known as","value":"HUDAK, KRISTEN ANN"}],"first":"KRISTEN","last":"KLEMENT TASSONE","middle":"ANN","credential":"M.D."},"specialty":{"primary_taxonomy":"2086S0122X","primary_taxonomy_description":"Plastic and Reconstructive Surgery Physician","slug":"plastic-and-reconstructive-surgery-physician","schema_org_specialty":null,"all":[{"code":"2086S0122X","description":"Plastic and Reconstructive Surgery Physician","primary":true,"state":"WI","license":"54773-20"}]},"addresses":[{"purpose":"LOCATION","street_1":"1155 N MAYFAIR RD","city":"WAUWATOSA","state":"WI","postal_code":"532263462","country_code":"US","phone":"4149554263","fax":"4149556286"},{"purpose":"MAILING","street_1":"1155 N MAYFAIR RD","city":"WAUWATOSA","state":"WI","postal_code":"532263462","country_code":"US","phone":"4149554263","fax":"4149556286"}],"license":{"state":"WI","number":"54773-20"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1912149170","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20160808001855","type_code":"14-24","type_desc":"PRACTITIONER - PLASTIC AND RECONSTRUCTIVE SURGERY","state":"WI","pac_id":"4385963800"}]},"enumeration_date":"2009-04-01","last_updated":"2024-02-22","_meta":{"source":"NPPES","snapshot_date":"2024-02-22","doc_url":"https://findmynpi.com/api"}}