NPIMap

Individual provider Active NPI

Jeffery R Smale, MD

  • Pulmonary Disease Physician
  • West Bend, WI
National Provider Identifier
1407930886
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
31391 Issued in WI
Practice address
3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone
(262) 334-3451
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31391 WI
Pulmonary Disease Physician 207RP1001X 31391 WI Primary

Addresses

Primary practice location

3200 Pleasant Valley Rd
West Bend, WI 53095-9274

Mailing address

1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451

Other identifiers 1

IdentifierTypeStateIssuer
3184000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100218000709 WI Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 9739262023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Medical College of Wisconsin, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Froedtert Andthe Medical College of Wisconsin Community Physicians Inc 1,265 clinicians

Practice addresses (Care Compare)

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

3212 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 334-6165

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

Hospital & facility affiliations

  • St Josephs Community Hospital West Bend Hospital, West Bend, WI, CCN 520063
  • Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31391WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Jan 1, 2015 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine Current Accepting new patients
St. Josephs Community Hospital of West Bend Inc. PastSince Jul 1, 2008 Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

1701 Fond du Lac Ave
Kewaskum, WI 53040
Phone (262) 626-4616

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: jsmalemd125752@direct.froedtert.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 2

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1407930886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959795",
            "telephone_number": "262-334-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "262-334-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALE",
        "first_name": "JEFFERY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "31391",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "31391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3184000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.