NPIMap

Individual provider Active NPI

Rose M Cipres-Jaucian, MD

  • Neonatal-Perinatal Medicine Physician
  • De Pere, WI
National Provider Identifier
1003867417
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
22782-20 Issued in WI
Practice address
1723 Spring Hills LN
De Pere, WI 54115-8369
Phone
(920) 403-7982
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 01056207A IN
Neonatal-Perinatal Medicine Physician 2080N0001X 22782-20 WI Primary

Addresses

Primary practice location

1723 Spring Hills LN
De Pere, WI 54115-8369

Mailing address

1723 Spring Hills LN
De Pere, WI 54115-8369

Other identifiers 4

IdentifierTypeStateIssuer
200935420MedicaidIN
34540600MedicaidWI
009906261IOtherHUMANA
000000603384OtherINANTHEM PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Wisconsin, SC Neonatal-Perinatal Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1003867417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 SPRING HILLS LN",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541158369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 SPRING HILLS LN",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541158369",
            "telephone_number": "920-403-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIPRES-JAUCIAN",
        "first_name": "ROSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01056207A",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WI",
            "license": "22782-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200935420",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34540600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "009906261I",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000603384",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.