Laura Jacques, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Deforest, WI
NPI 1336335686 · NPPES record last updated Feb 1, 2021
Key facts
- NPI
- 1336335686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 55905 (WI)
- Practice address
- 4200 Savannah Dr
Meriter Deforest-Windsor
Deforest, WI 53562 - Phone
- (608) 414-3300
- Fax
- (608) 417-3100
- NPI assigned
- Sep 20, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- University of Wisconsin School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Wisconsin Medical Foundation Inc
Practice addresses (Care Compare)
4200 Savannah Dr
De Forest, WI 53532-2909
Phone (608) 417-3300
Hospital & facility affiliations
- University of Wi Hospitals & Clinics Authority
- Unitypoint Health - Meriter
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.32 of 100
- Quality
- 87.78
- Promoting interoperability
- 77
- Improvement activities
- 40
- Cost
- 75.8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110715000260 | WI | Practitioner - Obstetrics/Gynecology | 6204004302 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55905 | WI | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Wisconsin Medical Foundation, Inc | Current |
Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Current |
Accepting new patients | |
| University of Wisconsin Medical Foundation, Inc | Current |
Accepting new patients | |
| Prohealth Medical Group Inc | Obstetrics & Gynecology | Past | Accepting new patients |
Locations
4200 Savannah Dr
Deforest, WI 53532
Phone (608) 417-3300
2402 Winnebago St
Madison, WI 53704
Phone (608) 242-6840
600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325
W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000
10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080
7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270
Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122
840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
Interoperability endpoints
- ljacques832831@direct.uwhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 55905 | WI | Yes |
Addresses
Primary practice location
4200 Savannah Dr
Meriter Deforest-Windsor
Deforest, WI 53562
Mailing address
7974 Uw Health CT
Middleton, WI 53562-5531
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336335686 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ljacques832831@direct.uwhealth.org |
Other providers in Deforest, WI
- Help for Neurodiverse Kids Corporation
- Jessica Hnilicka
- Amy L Hoffmann
- Kelly Hofstetter
- Tracy Lytle Huffstatler
- Jat Pharmacy, LLC
- Julie Christine Jones
- Torina Ruth Kehoe
- Farah Khan
- Daniel R Knuteson
All providers in Deforest, WI · Obstetrics & Gynecology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.