Individual provider Active NPI

Jenifer A Siragusa, DO

  • Family Medicine Physician
  • Madison, WI
National Provider Identifier
1053361246
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46430-021 Issued in WI
Practice address
7102 Mineral Point Rd
Madison, WI 53717-1706
Phone
(608) 828-7603
Fax
(608) 828-7644
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46430-021 WI Primary

Addresses

Primary practice location

7102 Mineral Point Rd
Madison, WI 53717-1706

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

2402 Winnebago St
Madison, WI 53704-5341
Phone (608) 242-6855

Other identifiers 1

IdentifierTypeStateIssuer
43522000MedicaidWI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050726001151 WI Practitioner - Family PracticePractitioner - Internal Medicine 4082641568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, 2,537 clinicians

Practice addresses (Care Compare)

7102 Mineral Point Rd
Madison, WI 53717-1706
Phone (608) 828-7603

Hospital & facility affiliations

  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46430-021WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Physician Practices LLC CurrentSince Sep 1, 2015 Accepting new patients
Watertown Physician Practices LLC Family Medicine CurrentSince Sep 1, 2015 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince May 1, 2021 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince May 1, 2021 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

11101 N Sherman Rd
Edgerton, WI 53534
Phone (608) 884-1695

540 Village Walk Ln
Ste J
Johnson Creek, WI 53038
Phone (920) 699-4388

1025 Mulberry St
Lake Mills, WI 53551
Phone (920) 261-9591

7102 Mineral Point Rd
Madison, WI 53717
Phone (608) 828-7603

2402 Winnebago St
Madison, WI 53704
Phone (608) 242-6840

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

111 Anna St
Waterloo, WI 53594
Phone (920) 478-3776

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1053361246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7102 MINERAL POINT RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171706",
            "telephone_number": "608-828-7603",
            "fax_number": "608-828-7644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2402 Winnebago St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537045341",
            "country_code": "US",
            "telephone_number": "608-242-6855",
            "fax_number": "608-242-6848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIRAGUSA",
        "first_name": "JENIFER",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "46430-021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43522000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.