Jackson Korger

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

84828-20 Issued in WI

Practice address

2253 W Mason St
Green Bay, WI 54303-4706

Phone

(920) 327-7000

Fax

(920) 327-7005

NPI assigned

Apr 5, 2022

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Wisconsin School of Medicine, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Baycare Clinic LLP

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1588609648
  Medicare reassignment NPD
• Baycare Clinic LLP

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1134490758
  NPD

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1659012672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034706",
            "telephone_number": "920-327-7000",
            "fax_number": "920-327-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORGER",
        "first_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "84828-20",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Komro, DO
• Tseun Han James Kong, M.B.B.CH, B.A.O.
• Margaret Jane Konopasek, PA-C
• Adam Koopmann
• Kailey Koponen
• Allison Paige Kornelly
• Amber L Kornely, NP
• Melany A Kornowske, OT
• Sara Kornowske, PHARMD
• Samantha Nicole Kornowski, LCSW, APSW, CSAC

• Ophthalmology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.