Individual provider Active NPI

Jacob Steven Clearfield

  • Physical Medicine & Rehabilitation Physician
  • Mount Pleasant, WI
National Provider Identifier
1629367776
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
60013 Issued in WI
Practice address
3811 Spring St
Mount Pleasant, WI 53405-1667
Phone
(262) 687-6262
Fax
(262) 687-6261
NPI assigned
Mar 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 60013 WI Primary

Addresses

Primary practice location

3811 Spring St
Mount Pleasant, WI 53405-1667

Mailing address

3811 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-6262

Other names 1

  • Jacob Steven Dickes Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150701002727 WI Practitioner - Physical Medicine and Rehabilitation 8820300916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3811 Spring St
Suite 301
Mount Pleasant, WI 53405-1667
Phone (262) 687-6260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jul 13, 2015 Accepting new patients
Wheaton Franciscan Medical Group Past Accepting new patients
Ascension All Saints Hospital, Inc Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3811 Spring St
Ste 102
Mount Pleasant, WI 53405
Phone (262) 687-5800

3811 Spring St
#102
Mount Pleasant, WI 53405
Phone (262) 687-5800

3811 Spring St
Ste 301
Mount Pleasant, WI 53405
Phone (262) 687-6260

3811 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-1600

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1629367776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-687-6262",
            "fax_number": "262-687-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-687-6262",
            "fax_number": "262-687-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARFIELD",
        "first_name": "JACOB",
        "middle_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "60013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACOB",
            "last_name": "DICKES",
            "middle_name": "STEVEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.