Individual provider Active NPI

Jeanne E Hryciuk, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • West Bend, WI
National Provider Identifier
1124006846
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
34521 Issued in WI
Practice address
3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone
(262) 836-7300
Fax
(262) 836-7301
NPI assigned
Jan 3, 2006
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 34521 WI Primary

Addresses

Primary practice location

3200 Pleasant Valley Rd
West Bend, WI 53095-9274

Mailing address

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

Other identifiers 1

IdentifierTypeStateIssuer
32323400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34521WIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripath Milwaukee SC Past Accepting new patients

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, 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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1124006846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-836-7300",
            "fax_number": "262-836-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-836-7300",
            "fax_number": "262-836-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRYCIUK",
        "first_name": "JEANNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "34521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32323400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.