Jeffrey D Gentile, MD
Individual provider Active NPI Family Medicine Physician · Mukwonago, WI
NPI 1699861021 · NPPES record last updated Oct 18, 2023
Key facts
- NPI
- 1699861021
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 48466020 (WI)
- Practice address
- 120 Chapman Farm Boulevard
Mukwonago, WI 53149 - Phone
- (262) 363-3894
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Medical College of Wisconsin, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Medical Group, Inc.
Practice addresses (Care Compare)
1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056
120 Chapman Farms Blvd
Mukwonago, WI 53149-9337
Phone (262) 363-6160
201 E Morrissey Dr
Elkhorn, WI 53121-4395
Phone (262) 723-3100
Hospital & facility affiliations
- Aurora Medical Center - Summit
- Waukesha Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070810000277 | WI | Practitioner - Family Practice | 1153412796 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48466020 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Commonwealth Medical Group, LLC | Family Medicine | Past |
Accepting new patients |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
120 Chapman Farm Blvd
Mukwonago, WI 53149
Phone (262) 363-6160
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
Interoperability endpoints
- jgentile223720@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 48466020 | WI | Yes |
Addresses
Primary practice location
120 Chapman Farm Boulevard
Mukwonago, WI 53149
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34910300 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jgentile223720@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Mukwonago, WI
- Amy Beth Flock
- Rita Foster
- Four a'S Helping Lives
- Jennifer L Friehe
- Kyla Galles
- William Harry Green
- Collin Patrick Groves
- H.S. Psychological Services SC
- Lisa Haisler
- Anthony Thomas Hall
All providers in Mukwonago, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.