Individual provider Active NPI

Geremiah Stephen Krause, PA-C

  • Physician Assistant
  • Mukwonago, WI
National Provider Identifier
1235432576
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3264 Issued in WI
Practice address
240 Maple Ave
Prohealth Care Medical Associates Inc.
Mukwonago, WI 53149-8475
Phone
(262) 928-1900
NPI assigned
Dec 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3264 WI Primary

Addresses

Primary practice location

240 Maple Ave
Prohealth Care Medical Associates Inc.
Mukwonago, WI 53149-8475

Mailing address

240 Maple Ave
Prohealth Care Medical Associates Inc.
Mukwonago, WI 53149-8475
Phone (262) 928-1900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140717000291 WI Practitioner - Physician Assistant 4880878560 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1011 Spring City Dr
Suite 250
Waukesha, WI 53186-5934
Phone (262) 928-0370

109 Air Park Dr
Watertown, WI 53094-7400
Phone (262) 928-5100

1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

2130 Big Bend Rd
Waukesha, WI 53189-7624
Phone (262) 928-7555

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900

2750 Golf Rd
Delafield, WI 53018-2062
Phone (262) 928-4900

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3264WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reedsburg Area Medical Center Inc CurrentSince Sep 1, 2018 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Jul 10, 2019 Accepting new patients
Prohealth Medical Group Inc CurrentSince Jul 10, 2019 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

725 American Ave
#5
Waukesha, WI 53188
Phone (262) 928-2475

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1235432576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MAPLE AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498475",
            "telephone_number": "262-928-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MAPLE AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498475",
            "telephone_number": "262-928-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "GEREMIAH",
        "middle_name": "STEPHEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-08",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukwonago, WI

Sources for this page

Verify at the official NPI Registry.