Individual provider Active NPI

Jolie Cetnarowski

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1578250429
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13798 Issued in WI
Practice address
11002 W Park PL
Milwaukee, WI 53224-3615
Phone
(888) 999-2404
NPI assigned
Apr 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP.AP.70092417-NP WA
Family Nurse Practitioner 363LF0000X 13798 WI Primary
Family Nurse Practitioner 363LF0000X 209035247 IL

Addresses

Primary practice location

11002 W Park PL
Milwaukee, WI 53224-3615

Mailing address

200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone (888) 562-5442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI, CA, SC, IL, WA6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20230503001137 WI Practitioner - Nurse Practitioner 3779948393 Reassigns benefits to 1 organization
I20230927002835 MI Practitioner - Nurse Practitioner 3779948393 Reassigns benefits to 1 organization
I20231009002552 CA Practitioner - Nurse Practitioner 3779948393 Reassigns benefits to 2 organizations
I20240309000757 SC Practitioner - Nurse Practitioner 3779948393 Reassigns benefits to 1 organization
I20260429000160 IL Practitioner - Nurse Practitioner 3779948393 Reassigns benefits to 1 organization
I20260521002723 WA Practitioner - Nurse Practitioner 3779948393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1792 Hickory St
South Milwaukee, WI 53172-1016

200 Oceangate
Suite 100
Long Beach, CA 90802-4316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209035247ILMDFamily Nurse Practitioner
ARNP.AP.70092417-NPWAMDFamily Nurse Practitioner
13798WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Health Plan of California, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Universal Care CurrentSince Nov 1, 2024 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

Interoperability endpoints

  • Direct secure messaging: jcetnarowski14470@direct-prd.molinahealthcare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1578250429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "888-562-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11002 W PARK PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243615",
            "telephone_number": "888-999-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CETNAROWSKI",
        "first_name": "JOLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "ARNP.AP.70092417-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "13798",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209035247",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.