Active NPI
Marijan Jednacak, MD
- Anesthesiology Physician
- Kenosha, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 45210020
- Practice address
- 10400 75TH St
Kenosha, WI 53142-7884 - Phone
- (262) 697-7000
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 45210020 | WI | Primary |
Addresses
Primary practice location
10400 75TH St
Kenosha, WI 53142-7884
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
5000 w chambers st
milwaukee, WI 53210
Phone (414) 447-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34609400 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mjednacak87892@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050127000912 | WI | Practitioner - Anesthesiology | 0749230605 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Medical Group, Inc.
Practice addresses (Care Compare)
1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056
10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000
13250 Washington Ave
Mount Pleasant, WI 53177-1516
Phone (262) 884-4000
8400 Washington Ave
Mount Pleasant, WI 53406-3735
Phone (262) 321-3000
Hospital & facility affiliations
- Aurora Medical Center Kenosha
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45210020 | WI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000
10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000
10117 74th St
Ste 110
Kenosha, WI 53142
Phone (262) 697-1919
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
8400 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 231-3000
620 15th Ave
Union Grove, WI 53182
Phone (262) 878-1211
W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000
4025 N 92nd St
Wauwatosa, WI 53222
Phone (414) 358-5431
Interoperability endpoints
- mjednacak87892@direct.myadvocateaurora.org
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 and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- Durable Medical Equipment & Medical Supplies
- Union Grove, WI
- NPI 1245440601
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kenosha, WI
- NPI 1225156888
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735776000000",
"number": "1104842707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 75TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531427884",
"telephone_number": "262-697-7000"
}
],
"practiceLocations": [
{
"address_1": "5000 w chambers st",
"address_purpose": "LOCATION",
"city": "milwaukee",
"state": "WI",
"postal_code": "53210",
"country_code": "US",
"telephone_number": "414-447-2000",
"fax_number": "414-874-4533",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JEDNACAK",
"first_name": "MARIJAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2025-01-02",
"certification_date": "2025-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "45210020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34609400",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mjednacak87892@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "10400 75th St",
"city": "Kenosha",
"state": "WI",
"country_code": "US",
"postal_code": "531427884",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "10400 75th St",
"city": "Kenosha",
"state": "WI",
"country_code": "US",
"postal_code": "531427884",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.