Individual provider Active NPI

Jeanette A Kalupa, N.P.

  • Nurse Practitioner
  • Muskego, WI
National Provider Identifier
1285690198
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2355033 Issued in WI
Practice address
S68W15500 Janesville Rd
Muskego, WI 53150-2613
Phone
(414) 422-4000
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2355033 WI Primary

Addresses

Primary practice location

S68W15500 Janesville Rd
Muskego, WI 53150-2613

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 2

IdentifierTypeStateIssuer
41182000MedicaidWI
P00314275OtherWIMEDICARE RAILROAD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jkalupa24762@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415001327 WI Practitioner - Nurse Practitioner 2365437787 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

S68W15500 Janesville Rd
Muskego, WI 53150-2613
Phone (414) 422-4000

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2355033WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. CurrentSince May 8, 2017 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince May 8, 2017 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince May 8, 2017 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince May 8, 2017 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 2, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 2, 2014 Accepting new patients
Cogent Healthcare of Wisconsin, SC Nurse Practitioner Past Accepting new patients
Indigo Hospital Medicine - Ludington, PLC Past Accepting new patients
Georgia Inpatient Medicine Associates, LLC Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

S68W15500 Janesville Rd
Muskego, WI 53150
Phone (414) 422-2180

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: jkalupa24762@direct.myadvocateaurora.org

Organizations & group practices 10

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 5

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1285690198",
    "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": "S68W15500 JANESVILLE RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531502613",
            "telephone_number": "414-422-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALUPA",
        "first_name": "JEANETTE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2355033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41182000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00314275",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkalupa24762@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "S68W15500 Janesville Rd",
            "city": "Muskego",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531502613",
            "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": "S68W15500 Janesville Rd",
            "city": "Muskego",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531502613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muskego, WI

Sources for this page

Verify at the official NPI Registry.