Alexandra Jelacic, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10476-33 Issued in WI

Practice address

725 American Ave
Waukesha, WI 53188-5031

Phone

(262) 928-1000

NPI assigned

Oct 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440
  Medicare reassignment Care Compare group NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)
• Watertown Physician Practices LLC

  • Obstetrics & Gynecology Physician
  • Watertown, WI
  • NPI 1225412265
  NPD (past)

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1669071809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-928-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-928-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELACIC",
        "first_name": "ALEXANDRA",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10476-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffog Medical Wi SC
• Jeffrey O'Brien, D.D.S., S.C.
• Jeffrey W Ausen DDS SC
• Gwendolyn K Jeffro, LPN
• Brevin Jay Jegerlehner, DPT
• Alyssa Jelinek
• Karen A Jenk
• Lynn C Jenkins, DO
• Richard H. Jenkins, M.D.
• Bailey Jensen, RDH

• Family Nurse Practitioner in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.