Individual provider Active NPI

Jamie L Kaminski

  • Nurse Practitioner
  • West Allis, WI
National Provider Identifier
1568074359
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9898 Issued in WI
Practice address
6609 W Greenfield Ave
West Allis, WI 53214-4958
Phone
(414) 257-8577
NPI assigned
Aug 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9898-33 WI
Nurse Practitioner 363L00000X 9898 WI Primary

Addresses

Primary practice location

6609 W Greenfield Ave
West Allis, WI 53214-4958

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
100134118MedicaidWI

Other names 1

  • Jamie Kivisto Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jderuiter115214@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201113002799 WI Practitioner - Nurse Practitioner 6901216381 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

138 N Ave
Suite 4
Hartland, WI 53029-1725
Phone (252) 256-3020

14555 W National Ave
Suite 175
New Berlin, WI 53151-4484
Phone (262) 827-3144

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9898WIMDNurse Practitioner
9898-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. CurrentSince Aug 30, 2021 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Aug 30, 2021 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Aug 30, 2021 Accepting new patients
Integrative Medicine Lake Country, LLC CurrentSince Nov 5, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

16985 W Bluemound Rd
Brookfield, WI 53005
Phone (262) 641-8400

9200 W Loomis Rd
Franklin, WI 53132
Phone (414) 529-9200

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

215 Washington St
Grafton, WI 53024
Phone (262) 375-3700

138 North Ave
Ste 4
Hartland, WI 53029
Phone (252) 256-3020

N84W16889 Menomonee Ave
Menomonee Fls, WI 53051
Phone (262) 251-7500

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2801 W Kinnickinnic River Pkwy
Ste 480
Milwaukee, WI 53215
Phone (414) 385-2317

6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

14555 W National Ave
Ste 175
New Berlin, WI 53151
Phone (262) 827-3144

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

1005 Spring City Dr
Waukesha, WI 53186
Phone (262) 301-2020

3289 N Mayfair Rd
Wauwatosa, WI 53222
Phone (414) 771-7900

6609 W Greenfield Ave
West Allis, WI 53214
Phone (414) 257-8500

Interoperability endpoints

  • Direct secure messaging: jderuiter115214@direct.myadvocateaurora.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1568074359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144958",
            "telephone_number": "414-257-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "JAMIE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9898-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100134118",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jderuiter115214@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 480",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 480",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "KIVISTO",
            "credential": "MSN, APNP, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.