NPIMap

Individual provider Active NPI

Jeffrey L White, D.O.

  • Family Medicine Physician
  • Platteville, WI
National Provider Identifier
1093761785
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38995 Issued in WI
Practice address
1240 Big Jack Rd
Platteville, WI 53818-8902
Phone
(608) 348-6266
Fax
(608) 342-3600
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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 38995 WI Primary
Family Medicine Physician 207Q00000X 03120 IA

Addresses

Primary practice location

1240 Big Jack Rd
Platteville, WI 53818-8902

Mailing address

1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100

Other identifiers 1

IdentifierTypeStateIssuer
30085000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050308000396 WI Practitioner - Family Practice 0244284792 Reassigns benefits to 1 organization
I20101012001177 IA Practitioner - Family Practice 0244284792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

1240 Big Jack Rd
Platteville, WI 53818-8902
Phone (608) 348-6266

1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions116
Removal of nail tissue1-10
Removal or shaving of skin growth40
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03120IAMDFamily Medicine Physician
38995WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates Clinic P C CurrentSince Jul 1, 1997 Accepting new patients

Locations

1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100

1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455

1240 Big Jack Rd
Platteville, WI 53818
Phone (608) 348-2844

Interoperability endpoints

  • Direct secure messaging: jwhite258815@direct-ehr-ssmhc.com

Organizations & group practices 1

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1093761785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4100",
            "fax_number": "563-584-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 BIG JACK RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538188902",
            "telephone_number": "608-348-6266",
            "fax_number": "608-342-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "38995",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30085000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Platteville, WI

Sources for this page

Verify at the official NPI Registry.