Jacob McChrystal, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16003-24 Issued in WI

Practice address

215 Washington St
Grafton, WI 53024-1700

Phone

(262) 375-3700

NPI assigned

Dec 8, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment Care Compare group NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment Care Compare group NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • Saint Francis, WI
  • NPI 1003861188

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1184335366",
    "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": "215 WASHINGTON ST",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530241700",
            "telephone_number": "262-375-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 S Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Cudahy",
            "state": "WI",
            "postal_code": "531103171",
            "country_code": "US",
            "telephone_number": "414-489-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCHRYSTAL",
        "first_name": "JACOB",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-08",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16003-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100259203",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcchrystal323744@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "215 Washington St",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530241700",
            "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": "215 Washington St",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530241700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jordan Michelle Markiewicz, LPC-IT
• John Scott Maul, MD
• Leslie May, NP
• Lisa Beth Mayer, RN
• Zach McCallips, MD
• Staccia McCulley, RN BSN
• Laura McFarlane
• Megan McHugh, MSN, NNP-BC, APNP
• Laura McKinnis, N.P.
• Maria McQuillan, OTR/L

• Physical Therapist in Grafton, WI
• Providers in Grafton, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.