NPIMap

Individual provider Active NPI

Jeffrey Alan Kowalski, MD

  • Family Medicine Physician
  • Elkhorn, WI
National Provider Identifier
1811169550
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54448-20 Issued in WI
Practice address
839 N Wisconsin St
Elkhorn, WI 53121-4541
Phone
(262) 741-1400
Fax
(262) 741-1401
NPI assigned
Apr 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 54448-20 WI Primary
Family Medicine Physician 207Q00000X A117482 CA

Addresses

Primary practice location

839 N Wisconsin St
Elkhorn, WI 53121-4541

Mailing address

839 N Wisconsin St
Elkhorn, WI 53121-4541
Phone (262) 741-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000336 WI Practitioner - Family Practice 2264600600 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians

Practice addresses (Care Compare)

839 N Wisconsin St Dba
Elkhorn, WI 53121-1138
Phone (262) 741-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A117482CAMDFamily Medicine Physician
54448-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Aug 12, 2013 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 12, 2013 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Family Medicine CurrentSince Aug 15, 2011 Accepting new patients
Mercy Health System Corporation Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

839 N Wisconsin St
Elkhorn, WI 53121
Phone (262) 723-5055

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: jkowalski25223@direct.mhemail.org

Organizations & group practices 5

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 6

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1811169550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 N WISCONSIN ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214541",
            "telephone_number": "262-741-1400",
            "fax_number": "262-741-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 N WISCONSIN ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214541",
            "telephone_number": "262-741-1400",
            "fax_number": "262-741-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "54448-20",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A117482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

Verify at the official NPI Registry.