NPIMap

Individual provider Active NPI

Tomasz M Jarzembowski, MD

  • Hospitalist Physician
  • Pleasant Prairie, WI
National Provider Identifier
1063636454
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
51431 Issued in WI
Practice address
9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone
(262) 577-8300
Fax
(262) 577-8414
NPI assigned
Apr 13, 2007
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51431 WI
Hospitalist Physician 208M00000X 51431 WI Primary

Addresses

Primary practice location

9555 76TH St
Pleasant Prairie, WI 53158-1984

Mailing address

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8300

Other identifiers 1

IdentifierTypeStateIssuer
35347200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080827000550 WI Practitioner - HospitalistPractitioner - Family Practice 1850490525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians
Vituity-Wisconsin HM SCGroup PAC ID 4880056126, 29 clinicians
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

3620 57TH Ave
Kenosha, WI 53144-4925
Phone (262) 925-5250

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8000

9809 39TH Ave
Pleasant Prairie, WI 53158-3733
Phone (262) 925-5080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51431WIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. Family Medicine CurrentSince Aug 4, 2008 Accepting new patients
Vituity-Wisconsin HM SC Hospitalist CurrentSince Aug 15, 2023 Accepting new patients
Froedtert South, Inc. Past Accepting new patients
Kenosha Pathology Consultants Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

Interoperability endpoints

  • Direct secure messaging: tjarzembowski341794@direct.froedtert.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1063636454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 76TH ST",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-577-8300",
            "fax_number": "262-577-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 76TH ST",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-577-8300",
            "fax_number": "262-577-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARZEMBOWSKI",
        "first_name": "TOMASZ",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "51431",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "51431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35347200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.