Individual provider Active NPI

William J Jeranek, MD

  • Family Medicine Physician
  • Pleasant Prairie, WI
National Provider Identifier
1013941194
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21271 Issued in WI
Practice address
9555 76TH Street
Pleasant Prairie, WI 53158
Phone
(262) 577-8300
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21271 WI Primary

Addresses

Primary practice location

9555 76TH Street
Pleasant Prairie, WI 53158

Mailing address

9555 76TH Street
Pleasant Prairie, WI 53158

Other identifiers 1

IdentifierTypeStateIssuer
30270200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101022001216 WI Practitioner - Family Practice 9931392875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

10222 74TH St
Suite 211
Kenosha, WI 53142-6810
Phone (262) 925-5020

3620 57TH Ave
Suite 400
Kenosha, WI 53144-4925
Phone (262) 925-5250

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21271WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. Family Medicine CurrentSince Nov 17, 1999 Accepting new patients
Kenosha Pathology Consultants Past Accepting new patients
Froedtert South, Inc. Past Accepting new patients

Locations

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

3535 30th Ave
Ste 101
Kenosha, WI 53144
Phone (262) 654-0260

9555 76th St
Fl 2
Pleasant Prairie, WI 53158
Phone (262) 577-8300

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

Interoperability endpoints

  • Direct secure messaging: wjeranek341704@direct.froedtert.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1013941194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 76TH STREET",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "53158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 76TH STREET",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "53158",
            "telephone_number": "262-577-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERANEK",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "21271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30270200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.