Individual provider Active NPI

Jennifer A Hoag, PHD

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1033342183
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2812-057 Issued in WI
Practice address
9000 W Wisconsin Ave
Pediatric Hematology/Oncology
Milwaukee, WI 53226-4874
Phone
(414) 456-4170
Fax
(414) 456-6543
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2812-057 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Pediatric Hematology/Oncology
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Pediatric Hematology/Oncology
Milwaukee, WI 53226-4874
Phone (414) 456-4170

Other identifiers 2

IdentifierTypeStateIssuer
1033342183MedicaidWI
2812-057OtherWILICENSE (WISCONSIN)

Other names 1

  • Jennifer A Cooper Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121205000532 WI Practitioner - Clinical Psychologist 0042462640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Specialty Group IncGroup PAC ID 2567813447, 206 clinicians

Practice addresses (Care Compare)

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-2000

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2812-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Specialty Group, Inc. CurrentSince Mar 24, 2024 Accepting new patients

Locations

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: jhoag7428@direct.chw.org

Organizations & group practices 2

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": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1033342183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC HEMATOLOGY/ONCOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-456-4170",
            "fax_number": "414-456-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "PEDIATRIC HEMATOLOGY/ONCOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-456-4170",
            "fax_number": "414-456-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOAG",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2812-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033342183",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE (WISCONSIN)",
            "identifier": "2812-057",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "COOPER",
            "middle_name": "A",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.