Individual provider Active NPI

Majed Jandali, MD

  • Surgery Physician
  • Pleasant Prairie, WI
National Provider Identifier
1679635171
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
34339 Issued in WI
Practice address
9555 76TH St Ste 4880
Pleasant Prairie, WI 53158-1984
Phone
(262) 748-1001
Fax
(262) 748-1020
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 34339 WI Primary

Addresses

Primary practice location

9555 76TH St Ste 4880
Pleasant Prairie, WI 53158-1984

Mailing address

9555 76TH St Ste 4880
Pleasant Prairie, WI 53158-1984
Phone (262) 748-1001

Other practice location 1

6308 8th Ave
Suite 3050
Kenosha, WI 53143-5031
Phone (262) 654-7002

Other identifiers 1

IdentifierTypeStateIssuer
31923800MedicaidWI

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
I20100624000951 WI Practitioner - General Surgery 2769451715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jandali Surgical Associates, S.C.Group PAC ID 2860461811, 2 clinicians

Practice addresses (Care Compare)

9555 76TH St
Suite 4880
Pleasant Prairie, WI 53158-1984
Phone (262) 748-1001

Hospital & facility affiliations

  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score
90.88 of 100Reported as group
Quality
100
Improvement activities
40
Cost
69.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Colonoscopy30
Hernia repair (minimally invasive)15
Mastectomy14
Upper gastrointestinal (GI) endoscopy for acid reflux21
Varicose vein removal12
Removal of tissue21
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jandali Surgical Associates, S.C. Surgery CurrentSince Jul 1, 1993 Accepting new patients

Locations

6308 8th Ave
Ste 3050
Kenosha, WI 53143
Phone (262) 654-7002

9555 76th St
Ste 4880
Pleasant Prairie, WI 53158
Phone (262) 654-7002

Interoperability endpoints

  • Direct secure messaging: mjandali347698@direct.froedtert.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GGJBBD

Organizations & group practices 1

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 1

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1679635171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 76TH ST STE 4880",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-748-1001",
            "fax_number": "262-748-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 76TH ST STE 4880",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-748-1001",
            "fax_number": "262-748-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6308 8th Ave",
            "address_2": "SUITE 3050",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531435031",
            "country_code": "US",
            "telephone_number": "262-654-7002",
            "fax_number": "262-654-6822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANDALI",
        "first_name": "MAJED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "34339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31923800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.