Jenna Ruth Haeberle, APRN, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

209.013259 Issued in IL

Practice address

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203

Phone

(414) 672-1353

NPI assigned

Feb 9, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jenna Ruth Petersdorf Former name

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

95.19 of 100Reported as apm

Quality

83.05

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhaeberle599623@direct.ochin.org

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.

• 16TH Street Community Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1417912999

  Advanced Practice Midwife

  Medicare reassignment NPD
• Columbia St. Mary's Hospital Milwaukee, Inc

  dba Ascension Columbia St Mary's Hospital Milwaukee

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482
  Medicare reassignment NPD
• Elmhurst Memorial Healthcare

  dba Elmhurst Clinic

  • Multi-Specialty Clinic/Center
  • Elmhurst, IL
  • NPI 1457493454
  Medicare reassignment NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment NPD
• Columbia St. Mary's Hospital Milwaukee Inc

  dba Ascension Columbia St Mary's Hospital Ozaukee

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD
• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1316587439

  Advanced Practice Midwife

  NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  NPD (past)
• Elmhurst Memorial Hospital

  dba Endeavor Health Elmhurst Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  NPD (past)
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  NPD (past)

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1033577762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778789",
            "telephone_number": "414-672-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "telephone_number": "414-672-1353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 N Westmoreland Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451674",
            "country_code": "US",
            "telephone_number": "224-241-4238",
            "fax_number": "847-615-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAEBERLE",
        "first_name": "JENNA",
        "middle_name": "RUTH",
        "credential": "APRN, CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WI",
            "license": "149030-32",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209.013259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100204747",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "PETERSDORF",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Babak Haddadian, MD
• Kay Ellen Haddenham, P.T.
• Mollie Haddigan-Mulberry, NP
• Ann J Hadley, M.S.
• Kathleen Marie Hadsell, AU.D.
• Haecceity Supportive Care LLC
• Rebecca A Haefner, MD
• Kent A. Haefs, O.D.
• Elizabeth Haeger, NP-C
• Ashley Faye Haen

• Advanced Practice Midwife in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Advanced Practice Midwife in Wisconsin

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

Verify at the official NPI Registry.