Jennifer L Maciolek, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4159 Issued in WI

Practice address

N112W17975 Mequon Rd
Germantown, WI 53022-2425

Phone

(262) 532-7600

NPI assigned

Mar 15, 2007

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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1740314699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-389-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N112W17975 MEQUON RD",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530222425",
            "telephone_number": "262-532-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N168W20060 Main St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "WI",
            "postal_code": "530379382",
            "country_code": "US",
            "telephone_number": "262-677-3661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACIOLEK",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40382500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "N168W20060 Main St",
            "city": "Jackson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530379382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmaciolek13762@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "N168W20060 Main St",
            "city": "Jackson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530379382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon Lee Loga, P.T.
• Lindsey R Lorenz, PA-C
• Jason L Luecht, D.D.S.
• Roy E. Luecht, D.D.S.
• Lynne M Krebs Crna SC
• Naheed S Madani, DDS
• Mahalko Family Chiropractic LLC
• Ben R Mahalko, D.C.
• Sara J Mahalko, D.C.
• Lindsey Maier

• Physical Therapist in Germantown, WI
• Providers in Germantown, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.