Jennifer Anne Luedke, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

601 N 99TH St
Suite 101
Wauwatosa, WI 53226-4339

Phone

(414) 988-5100

Fax

(414) 988-5102

NPI assigned

May 19, 2006

Last updated

Oct 26, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jennifer Anne Mirenda Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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

• Integrated Spine Care, S.C.

  • Orthopaedic Surgery of the Spine Physician
  • Wauwatosa, WI
  • NPI 1245212414
  NPD (past)
• Orthopaedic Associates of Wisconsin, SC

  • Orthopaedic Surgery Physician
  • Pewaukee, WI
  • NPI 1689656951
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1033162078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N 99TH ST",
            "address_2": "SUITE 101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264339",
            "telephone_number": "414-988-5100",
            "fax_number": "414-988-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 99TH ST",
            "address_2": "SUITE 101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264339",
            "telephone_number": "414-988-5100",
            "fax_number": "414-988-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDKE",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MIRENDA",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lowtwillc
• Margaret Alice Lucano, PTA
• Cheryl Ann Lucas-Deberry, LPC-IT
• Raymond Lueck, PSY.D.
• Sarah Luecke
• George Steven Lukats, D.D.S
• Tessa Anne Lundgren, DVM
• Lutheran Counseling & Family Services
• Lutheran Counseling & Family Services of Wisconsin (none)
• Lutheran Counseling and Family Services of Wisconsin Inc

• Physician Assistant in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.