Jasna Coralic, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

62416-20 Issued in WI

Practice address

2350 N Lake Dr
Suite 304
Milwaukee, WI 53211-4528

Phone

(414) 298-7233

Fax

(414) 298-7229

NPI assigned

Jun 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Colorectal Surgery (Proctology)

Education

Rush Medical College of Rush University, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Madison Medical Affiliates IncGroup PAC ID 5991606337, 86 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Madison Medical Affiliates, Inc.

  • General Practice Physician
  • Milwaukee, WI
  • NPI 1588695746
  Medicare reassignment Care Compare group NPD
• Columbia St. Mary'S Hospital Milwaukee, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482
  Medicare reassignment NPD
• Columbia St. Mary'S Hospital Milwaukee Inc

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD
• Columbia St. Mary'S Hospital Milwaukee, Inc

  • Psychiatric Hospital Unit
  • Milwaukee, WI
  • NPI 1811926132
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia St. Mary'S Hospital Milwaukee, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1871656082
  Care Compare affiliation

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1528296753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST",
            "address_2": "SUITE 300/ATTN. KAAREN BUTZEN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023718",
            "telephone_number": "414-272-8950",
            "fax_number": "414-272-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "address_2": "SUITE 304",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-298-7233",
            "fax_number": "414-298-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORALIC",
        "first_name": "JASNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "62416-20",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "WI",
            "license": "62416-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528296753",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna K Coppin, NP
• Angela Copploe, OD
• Catherine Maria Coppolillo, PH.D.
• Mary M Copps, OTR
• Melissa Corado, DDS
• Alecia Corbett, MSW
• Brooke Nicole Corbett, AGACNP-BC
• Lisa Marie Corbine, RN
• Samuel Kress Corbo, MD
• Delia Ivette Corchado

• Colon & Rectal Surgery Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Colon & Rectal Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.