Jacob Thayer, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

81973 Issued in WI

Practice address

W307N1497 Golf Rd Ste 200
Delafield, WI 53018-2112

Phone

(920) 627-2735

NPI assigned

Jun 24, 2016

Last updated

Sep 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4

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.

• Madison Medical Affiliates, Inc.

  • General Practice Physician
  • Milwaukee, WI
  • NPI 1588695746
  Medicare reassignment NPD
• Thayer Surgical LLC

  • Plastic Surgery Physician
  • Delafield, WI
  • NPI 1710676846
  Authorized official Same address or phone

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1326499930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W307N1497 GOLF RD STE 200",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182112",
            "telephone_number": "920-627-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W307N1497 GOLF RD STE 200",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182112",
            "telephone_number": "920-627-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "125.069338",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "81973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Malcolm Szafir
• Jacquelyn Szalacinski, BSN, RN, IBCLC, CLC
• Rebecca Taylor, PHARMD
• Theresa Marie Tengler, RD
• Thayer Surgical LLC
• The Eyeglassery, Co
• Thomas Richard Tomaszewski, PTA
• Total Renal Care Inc (Lake Country Dialysis)
• Elise Jennifer Trasser, LAC
• Tri-Motion Rehab LLC

• Plastic Surgery Physician in Delafield, WI
• Providers in Delafield, WI by specialty
• Plastic Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.