Active NPI
Jamie Clementi, MD
- Surgery Physician
- Oak Lawn, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036.164882
- Practice address
- 4440 W 95TH St
Oak Lawn, IL 60453-2600 - Phone
- (708) 684-8000
- NPI assigned
- Mar 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036.164882 | IL | Primary |
Addresses
Primary practice location
4440 W 95TH St
Oak Lawn, IL 60453-2600
Mailing address
2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-4175
Other practice location 1
2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-4175
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Loyola University of Chicago, Stritch School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
212 Milwaukee Ave W
Fort Atkinson, WI 53538-2022
Phone (920) 563-7900
Hospital & facility affiliations
- Fort Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 89 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 43 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.164882 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Healthcare Inc | Surgery | Current | Accepting new patients |
| Fort Healthcare Inc | Current | Accepting new patients | |
| Fort Healthcare, Inc. | Current | Accepting new patients |
Locations
704 Katie Ct
Cambridge, WI 53523
Phone (608) 423-1100
212 Milwaukee Ave W
Fort Atkinson, WI 53538
Phone (920) 563-7900
611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667
512 Wilcox St
Fort Atkinson, WI 53538
Phone (920) 563-7366
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/
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.
-
- Rural Health Clinic/Center
- Fort Atkinson, WI
- NPI 1417450115
-
- General Acute Care Hospital
- Fort Atkinson, WI
- NPI 1811916281
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Atkinson, WI
- NPI 1811916281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1023513355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 HOLMES ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641082640",
"telephone_number": "816-404-4175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532600",
"telephone_number": "708-684-8000"
}
],
"practiceLocations": [
{
"address_1": "2301 Holmes St",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641082640",
"country_code": "US",
"telephone_number": "816-404-4175",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLEMENTI",
"first_name": "JAMIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-28",
"last_updated": "2023-06-01",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036.164882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.