Individual provider Active NPI

Jennifer Minessale

  • Adult Health Nurse Practitioner
  • Mount Pleasant, WI
National Provider Identifier
1649597519
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4036-033 Issued in WI
Practice address
3809 Spring St
Mount Pleasant, WI 53405-1667
Phone
(262) 785-2273
NPI assigned
Apr 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4036-033 WI Primary

Addresses

Primary practice location

3809 Spring St
Mount Pleasant, WI 53405-1667

Mailing address

3809 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 785-2273

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
I20100921000748 WI Practitioner - Nurse Practitioner 9436274990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3809 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4036-033WIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jan 3, 2022 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Mar 2, 2023 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Mar 2, 2023 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients

Locations

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

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

2350 N Lake Dr
Ste 201
Milwaukee, WI 53211
Phone (414) 272-3000

2350 N Lake Dr
Ste 100
Milwaukee, WI 53211
Phone (414) 298-7250

3809 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-5000

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

1451 Cleveland Ave
Waukesha, WI 53186
Phone (262) 547-2123

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

725 American Ave
#108
Waukesha, WI 53188
Phone (262) 928-2570

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

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1649597519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-785-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-785-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINESSALE",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "4036-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.