Jeremy L Kaup, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

13690-33 Issued in WI

Practice address

3224 Kennsington Square Rd
Sturtevant, WI 53177-2821

Phone

(262) 762-9284

Fax

(262) 419-3818

NPI assigned

Mar 7, 2023

Last updated

Feb 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Professional Services Group Inc.Group PAC ID 8224296454, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Professional Services Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kenosha, WI
  • NPI 1619024262
  Medicare reassignment Care Compare group NPD
• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  Nurse Practitioner

  Medicare reassignment NPD
• Gray Matter Solutions LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sturtevant, WI
  • NPI 1194549089
  NPD Authorized official

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1649970773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 4TH ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031005",
            "telephone_number": "262-206-0412",
            "fax_number": "262-419-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 KENNSINGTON SQUARE RD",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531772821",
            "telephone_number": "262-762-9284",
            "fax_number": "262-419-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUP",
        "first_name": "JEREMY",
        "middle_name": "L",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13690-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "13690-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula J Hatch, OT
• Hinson Family Vision
• Douglas Mark Hinson, O.D.
• Islam Alaa Ibrahim Mahdy Ibrahim, DDS
• Sahar A Karimuddin, B.D.S.
• Jason A Kempinski, D.M.D.
• Ahmad Zia Khan, M.D.
• Lori Ann Koralewski, LPN
• Jeanie Marie Kramer I, NP
• Michelene C Larrabee, PA

• Psychiatric/Mental Health Nurse Practitioner in Sturtevant, WI
• Providers in Sturtevant, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.

Verify at the official NPI Registry.