Active NPI
Jonathan Gregory Tlachac, MD
- Anesthesiology Physician
- Grafton, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 54241
- Practice address
- 975 Port Washington Rd
Grafton, WI 53024-9201 - Phone
- (262) 329-2135
- NPI assigned
- May 29, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 54241 | WI | Primary |
| Anesthesiology Physician | 207L00000X | MD436211 | PA |
Addresses
Primary practice location
975 Port Washington Rd
Grafton, WI 53024-9201
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (262) 329-2135
Other practice location 1
9200 W Wisconsin Ave
Department of Anesthesiology
Milwaukee, WI 53226-3522
Phone (414) 805-8700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100008639 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jtlachac177580@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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Utah School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
975 Port Washington Rd
Grafton, WI 53024-9204
Phone (262) 329-8650
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD436211 | PA | MD | Anesthesiology Physician |
| 54241 | WI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Anesthesiology | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients |
Locations
975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000
Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
Interoperability endpoints
- jtlachac177580@direct.myadvocateaurora.org
Organizations & group practices 3
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Anesthesiology
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grafton, WI
- NPI 1265740195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1629204078",
"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",
"telephone_number": "262-329-2135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 PORT WASHINGTON RD",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530249201",
"telephone_number": "262-329-2135"
}
],
"practiceLocations": [
{
"address_1": "9200 W Wisconsin Ave",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532263522",
"country_code": "US",
"telephone_number": "414-805-8700",
"fax_number": "414-259-1522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TLACHAC",
"first_name": "JONATHAN",
"middle_name": "GREGORY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-29",
"last_updated": "2023-10-09",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "54241",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MD436211",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100008639",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jtlachac177580@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "9200 W Wisconsin Ave",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532263522",
"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": "9200 W Wisconsin Ave",
"address_2": "DEPARTMENT OF ANESTHESIOLOGY",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532263522",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Grafton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.