Individual provider Active NPI

Alyssa Jelinek

  • Neonatal Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1033779509
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
11714 Issued in WI
Practice address
725 American Ave
Waukesha, WI 53188-5031
Phone
(262) 928-1000
NPI assigned
Jun 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2473316 MN
Registered Nurse 163W00000X 172471 WI
Neonatal Nurse Practitioner 363LN0000X 6702 MN
Neonatal Nurse Practitioner 363LN0000X 11714 WI Primary

Addresses

Primary practice location

725 American Ave
Waukesha, WI 53188-5031

Mailing address

725 American Ave
Waukesha, WI 53188-5031

Other practice location 1

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Alyssa.Jelinek@ssmhealth.com Direct SSM Health Care of Wisconsin, Inc.

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220210000187 WI Practitioner - Nurse Practitioner 6608102694 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
172471WIMDRegistered Nurse
11714WIMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Jan 1, 2024 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jan 1, 2024 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Feb 1, 2022 Accepting new patients
Prohealth Medical Group Inc CurrentSince Feb 1, 2022 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients
Neonatal Resources of Wisconsin, Inc Past Accepting new patients

Locations

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

Interoperability endpoints

  • Direct secure messaging: alyssa.jelinek@ssmhealth.com
  • Direct secure messaging: ajelinek271298@direct-ehr-ssmhc.com

Organizations & group practices 7

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1033779509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-928-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044518",
            "country_code": "US",
            "telephone_number": "612-813-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JELINEK",
        "first_name": "ALYSSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2473316",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "172471",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MN",
            "license": "6702",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WI",
            "license": "11714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Alyssa.Jelinek@ssmhealth.com",
            "affiliation": "Y",
            "endpointDescription": "Work Email, Secure",
            "affiliationName": "SSM Health Care of Wisconsin, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Work Email",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.