Individual provider Active NPI

Janice Gaeth

  • Audiologist
  • Racine, WI
National Provider Identifier
1093921371
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
78 Issued in WI
Practice address
3811 Spring St
Suite 303
Racine, WI 53405-1667
Phone
(262) 687-8210
NPI assigned
May 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 78 WI Primary

Addresses

Primary practice location

3811 Spring St
Suite 303
Racine, WI 53405-1667

Mailing address

3811 Spring St
Suite 303
Racine, WI 53405-1667
Phone (262) 687-8210

Other identifiers 1

IdentifierTypeStateIssuer
41128200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118001026 WI Practitioner - Qualified Audiologist 6901855824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

709 Spring Valley Rd
Burlington, WI 53105-7614
Phone (262) 767-6020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
78WIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Audiologist Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

709 Spring Valley Rd
Burlington, WI 53105
Phone (262) 767-6020

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093921371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 SPRING ST",
            "address_2": "SUITE 303",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-687-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 SPRING ST",
            "address_2": "SUITE 303",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-687-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETH",
        "first_name": "JANICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "78",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41128200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.