Individual provider Active NPI

Jacob Laine, M.D.

  • Gastroenterology Physician
  • Milwaukee, WI
National Provider Identifier
1679969307
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
66853-20 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy Ste 1080
Milwaukee, WI 53215-3689
Phone
(414) 908-6506
Fax
(414) 908-6510
NPI assigned
Apr 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 66853-20 WI
Gastroenterology Physician 207RG0100X 66853-20 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy Ste 1080
Milwaukee, WI 53215-3689

Mailing address

2801 W Kinnickinnic River Pkwy Ste 1080
Milwaukee, WI 53215-3689
Phone (414) 908-6506

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
I20210723002487 WI Practitioner - Gastroenterology 9032425541 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Medical College of Wisconsin, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Gastroenterology Specialists SCGroup PAC ID 3375626195, 29 clinicians
Gi Associates LLCGroup PAC ID 6103738562, 55 clinicians
Milwaukee Gi Specialists SCGroup PAC ID 8123930542, 15 clinicians

Practice addresses (Care Compare)

1033 N Mayfair Rd
Suite 101
Wauwatosa, WI 53226-3442
Phone (414) 454-0600

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy85
Upper gastrointestinal (GI) endoscopy for acid reflux76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66853-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Gi Specialists SC Gastroenterology CurrentSince Aug 1, 2021 Accepting new patients
Gastroenterology Specialists SC Gastroenterology CurrentSince Jul 31, 2025 Accepting new patients
Gi Associates LLC Gastroenterology CurrentSince Aug 1, 2021 Accepting new patients

Locations

17000 W North Ave
Ste 105E
Brookfield, WI 53005
Phone (262) 786-6420

19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000

2801 W Kinnickinnic River Pkwy
Ste 1080
Milwaukee, WI 53215
Phone (414) 908-6506

240 Maple Ave
Ste 2220
Mukwonago, WI 53149

240 Maple Ave
Ste 2200
Mukwonago, WI 53149

1185 Corporate Center Dr
Ste 120
Oconomowoc, WI 53066
Phone (262) 289-1024

1185 Corporate Center Dr
Ste 125
Summit, WI 53066
Phone (262) 567-3600

1111 Delafield St
Ste 322
Waukesha, WI 53188
Phone (262) 650-7322

1033 N Mayfair Rd
Ste 101
Wauwatosa, WI 53226

1033 N Mayfair Rd
Ste 104
Wauwatosa, WI 53226

Interoperability endpoints

  • Direct secure messaging: jlaine152588@direct.phci.org

Organizations & group practices 3

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1679969307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 1080",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153689",
            "telephone_number": "414-908-6506",
            "fax_number": "414-908-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 1080",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153689",
            "telephone_number": "414-908-6506",
            "fax_number": "414-908-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAINE",
        "first_name": "JACOB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "66853-20",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "66853-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.