Jaeger Ackerman, MD
Individual provider Active NPI Psychiatry Physician · Madison, WI
NPI 1578192589 · NPPES record last updated Dec 8, 2022
Key facts
- NPI
- 1578192589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 76587-20 (WI)
- Practice address
- Uw Hospitals & Clinics 600 Highland Ave
Madison, WI 53792-0001 - Phone
- (608) 263-6400
- NPI assigned
- Apr 2, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, 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 |
|---|---|---|---|---|
| I20230926003157 | MN | Practitioner - Psychiatry | 4981027729 | Reassigns benefits to 1 organization |
| I20240805001599 | WI | Practitioner - Psychiatry | 4981027729 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76587-20 | WI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rogers Memorial Hospital Incorporated | Current |
Accepting new patients | |
| Hutchinson Health | Current |
Accepting new patients |
Locations
1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358
34700 Valley Rd
Oconomowoc, WI 53066
11101 W Lincoln Ave
West Allis, WI 53227
Phone (414) 203-4500
2424 S 102nd St
West Allis, WI 53227
Phone (414) 373-7474
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 76587-20 | WI | Yes |
Addresses
Primary practice location
Uw Hospitals & Clinics 600 Highland Ave
Madison, WI 53792-0001
Mailing address
Uw Hospitals & Clinics 600 Highland Ave
Madison, WI 53792-0001
Other practice location 1
11101 W Lincoln Ave
West Allis, WI 53227-1133
Phone (262) 646-4411
Other providers in Madison, WI
- Clare Allison Achia
- Achorcareplus LLC
- Carleen J Acker
- Jessica Ann Acker
- Allison Jeanne Ackerman
- Lynn A Acosta
- Active Care LLC
- Activeear, LLC
- Actra Rehabilitation Associates Inc
- John Adair
All providers in Madison, WI · Psychiatry 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 Dec 8, 2022. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.