Individual provider Active NPI

Jeffrey Scott Nelson, PA-C

  • Physician Assistant
  • Waukesha, WI
National Provider Identifier
1760502942
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2315 E Moreland Blvd
Waukesha, WI 53186-2939
Phone
(262) 532-5700
NPI assigned
Mar 30, 2007
Last updated
Mar 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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 NU Primary

Addresses

Primary practice location

2315 E Moreland Blvd
Waukesha, WI 53186-2939

Mailing address

N74W24316 Viola CT
Sussex, WI 53089-5408
Phone (262) 349-6214

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
I20070727000718 WI Practitioner - Physician Assistant 4981705498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2315 E Moreland Blvd
Waukesha, WI 53186-2939
Phone (262) 532-5700

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 15, 2016 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 15, 2016 Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients
Froedtert & the Medical College of Wisconsin Community Physicians Inc. Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

2315 E Moreland Blvd
Waukesha, WI 53186
Phone (262) 532-5700

237 Wisconsin Ave
Waukesha, WI 53186
Phone (262) 446-0363

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1760502942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N74W24316 VIOLA CT",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530895408",
            "telephone_number": "262-349-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862939",
            "telephone_number": "262-532-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.