Active NPI
Jandali Surgical Associates, S.C.
- Surgery Physician
- Pleasant Prairie, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 34339
- Legal business name
- JANDALI SURGICAL ASSOCIATES, S.C.
- Practice address
- 9555 76TH St Ste 4880
Pleasant Prairie, WI 53158-1984 - Phone
- (262) 748-1001
- Fax
- (262) 748-1020
- NPI assigned
- Feb 14, 2007
- Last updated
- Oct 17, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Majed Jandali, M.D.
- Title
- Owner/Medical Doctor
- Phone
- (262) 748-1001
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 34339 | WI | Primary |
Addresses
Primary practice location
9555 76TH St Ste 4880
Pleasant Prairie, WI 53158-1984
Mailing address
9555 76TH St Ste 4880
Pleasant Prairie, WI 53158-1984
Phone (262) 748-1001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
6308 8th Ave
#3050
Kenosha, WI 53143
Phone (262) 654-7002
6308 8th Ave
Ste 305
Kenosha, WI 53143
Phone (262) 654-7002
6308 8th Ave
Ste 3050
Kenosha, WI 53143
Phone (262) 654-7002
9555 76th St
Ste 4880
Pleasant Prairie, WI 53158
Phone (262) 654-7002
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GGJBBD
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Surgery Physician
- Pleasant Prairie, WI
- NPI 1679635171
-
- Surgery Physician
- Kenosha, WI
- NPI 1083744486
-
- Physician Assistant
- Milwaukee, WI
- NPI 1558391904
-
- Physician Assistant
- Pleasant Prairie, WI
- NPI 1609730100
-
- Surgery Physician
- Fond Du Lac, WI
- NPI 1144382656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1665964800000",
"number": "1528101433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9555 76TH ST STE 4880",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531581984",
"telephone_number": "262-748-1001",
"fax_number": "262-748-1020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555 76TH ST STE 4880",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531581984",
"telephone_number": "262-748-1001",
"fax_number": "262-748-1020"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JANDALI SURGICAL ASSOCIATES, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-14",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A",
"authorized_official_last_name": "JANDALI",
"authorized_official_first_name": "MAJED",
"authorized_official_title_or_position": "OWNER/MEDICAL DOCTOR",
"authorized_official_telephone_number": "262-748-1001",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "WI",
"license": "34339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pleasant Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.