Individual provider Active NPI

Jenna Cook, PA-C

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1730669565
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4500 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy Ste 260
Milwaukee, WI 53215-3669
Phone
(414) 649-6030
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4500 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy Ste 260
Milwaukee, WI 53215-3669

Mailing address

2801 W Kinnickinnic River Pkwy Ste 260
Milwaukee, WI 53215-3669

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jwaite189642@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181002001882 WI Practitioner - Physician Assistant 5092067082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 489-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4500WIMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2018 Accepting new patients

Locations

2801 W Kinnickinnic River Pkwy
Ste 260
Milwaukee, WI 53215
Phone (414) 649-6780

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

Interoperability endpoints

  • Direct secure messaging: jwaite189642@direct.myadvocateaurora.org

Organizations & group practices 2

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 2

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": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1730669565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 260",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 260",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-649-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JENNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwaite189642@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 260",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 260",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.