Active NPI
Jennifer Diane Johnson, FNP
- Family Nurse Practitioner
- Waukesha, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 6088-33
- Practice address
- 725 American Avenue
Waukesha, WI 53188 - Phone
- (212) 928-8800
- Fax
- (262) 928-0648
- NPI assigned
- Oct 27, 2014
- Last updated
- Dec 12, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 6088-33 | WI | |
| Registered Nurse | 163W00000X | 171464-30 | WI | |
| Family Nurse Practitioner | 363LF0000X | 6088-33 | WI | Primary |
Addresses
Primary practice location
725 American Avenue
Waukesha, WI 53188
Mailing address
27431 N. Lake Drive
Waterford, WI 53185
Phone (608) 358-8449
Other practice location 1
725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-8800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100041913 | Medicaid | WI |
Other names 1
- Jennifer Diane Psota
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | jpsota134940@direct.myadvocateaurora.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600
725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-7276
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171464-30 | WI | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc. | Current | Accepting new patients | |
| West Allis Memorial Hospital, Inc. | Current | Accepting new patients | |
| Prohealth Medical Group Inc | Current | Accepting new patients | |
| West Allis Memorial Hospital, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Great Lakes Pathologists SC | Current | Accepting new patients | |
| A2Cl Services, LLC | Current | Accepting new patients | |
| Comprehensive Cardiovascular Care, LLP | Past | Accepting new patients | |
| Prohealth Medical Group Inc | Past | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111
2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590
2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 385-3084
2901 W Kinnickinnic River Pkwy
Ste 315
Milwaukee, WI 53215
Phone (414) 385-2590
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011
N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000
Organizations & group practices 11
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.
-
- Pediatrics Physician
- Waukesha, WI
- NPI 1356322440
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
dba Aurora West Allis Medical Center
- General Acute Care Hospital
- West Allis, WI
- NPI 1407801640
-
- Clinical Medical Laboratory
- West Allis, WI
- NPI 1710064811
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- Anatomic Pathology & Clinical Pathology Physician
- West Allis, WI
- NPI 1689695934
-
- Family Medicine Physician
- Hartland, WI
- NPI 1386785178
-
dba Aurora West Allis Medical Center
- Rehabilitation Hospital Unit
- West Allis, WI
- NPI 1376717785
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
-
- Cardiovascular Disease Physician
- Appleton, WI
- NPI 1740457217
-
- Family Medicine Physician
- Waukesha, WI
- NPI 1790720613
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Waukesha, WI
- NPI 1629056890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1043615560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27431 N. LAKE DRIVE",
"city": "WATERFORD",
"state": "WI",
"postal_code": "53185",
"telephone_number": "608-358-8449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 AMERICAN AVENUE",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "53188",
"telephone_number": "212-928-8800",
"fax_number": "262-928-0648"
}
],
"practiceLocations": [
{
"address_1": "725 American Ave",
"address_purpose": "LOCATION",
"city": "Waukesha",
"state": "WI",
"postal_code": "531885031",
"country_code": "US",
"telephone_number": "262-928-8800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "JENNIFER",
"middle_name": "DIANE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-27",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "6088-33",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "171464-30",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "6088-33",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100041913",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2901 W Kinnickinnic River Pkwy",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532153677",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jpsota134940@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2901 W Kinnickinnic River Pkwy",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532153677",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "PSOTA",
"middle_name": "DIANE",
"credential": "FNP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.