Organization Active NPI

Jeremy a Schwartz DPM Wisconsin LTD

  • Podiatrist
  • Kenosha, WI
National Provider Identifier
1124699624
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
JEREMY A SCHWARTZ DPM WISCONSIN LTD
Practice address
8633 32ND Ave
Kenosha, WI 53142-5187
Phone
(694) 262-8300
NPI assigned
Jul 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Authorized official

Name
Jeremy Schwartz, DPMNPI 1861739484
Title
Owner
Phone
(773) 766-9444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

8633 32ND Ave
Kenosha, WI 53142-5187

Mailing address

3580 Grove St
Evanston, IL 60203-1821

Other names 1

  • Complete Podiatry Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210927002997 WI Part B Supplier - Clinic/Group Practice 7618374042 Receives reassigned benefits from 2 practitioners
Practice locations: Madison, WI

National Provider Directory

National Provider Directory

Locations

517 E Division St
Fond du Lac, WI 54935
Phone (920) 539-4707

8633 32nd Ave
Kenosha, WI 53142
Phone (262) 694-8300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1124699624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 GROVE ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602031821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8633 32ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531425187",
            "telephone_number": "694-262-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY A SCHWARTZ DPM WISCONSIN LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-766-9444",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Podiatry Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.