Jennifer Bleak, MD
Individual provider Active NPI Psychiatry Physician · Beloit, WI
NPI 1013124239 · NPPES record last updated Oct 4, 2021
Key facts
- NPI
- 1013124239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 036-083757 (WI)
- Practice address
- Beloit Health System Counselling Care Center
1969 W. Hart Rd
Beloit, WI 53511-2230 - Phone
- (608) 364-5689
- Fax
- (608) 364-5525
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.93 of 100
- Quality
- 64.82
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.63
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-083757 | WI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beloit Clinic, S.C. | Current | Accepting new patients | |
| Shorehaven Behavioral Health Inc | Psychiatry | Current |
Accepting new patients |
| Shorehaven Behavioral Health Inc | Psychiatry | Current |
Accepting new patients |
| Beloit Health System, Inc | Current |
Accepting new patients | |
| Beloit Health System Inc | Current |
Accepting new patients |
Locations
1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293
1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510
1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011
3900 W Brown Deer Rd
Ste 200
Milwaukee, WI 53209
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 50247-20 | WI | |
| Psychiatry Physician | 2084P0800X | 036-083757 | WI | Yes |
Addresses
Primary practice location
Beloit Health System Counselling Care Center
1969 W. Hart Rd
Beloit, WI 53511-2230
Mailing address
Beloit Health System Counselling Care Center
1969 W. Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5689
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100002708 | Medicaid | WI |
Other providers in Beloit, WI
- Shana Best
- Jenniffer Beu
- Indira Bhagwandin
- Bradley James Billeter
- Teresa Bingham
- Blessed Beginnings, Inc.
- David Andrew Block
- Brittany Noel Rowe Blomberg
- John Works Boardman
- Loria R. Boone
All providers in Beloit, WI · Psychiatry Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.