Individual provider Active NPI

Jennifer A Mikulich, RD CD

  • Registered Dietitian
  • Wausau, WI
National Provider Identifier
1831128669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
370 Issued in WI
Practice address
2720 Plaza Dr
Suite 1400
Wausau, WI 54401-4158
Phone
(715) 847-2070
NPI assigned
Jul 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 370 WI Primary

Addresses

Primary practice location

2720 Plaza Dr
Suite 1400
Wausau, WI 54401-4158

Mailing address

3000 Westhill Dr
Suite 303
Wausau, WI 54401-3795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090806000244 WI Practitioner - Registered Dietitian Or Nutrition Professional 2163575283 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medical Group, Inc.Group PAC ID 1052223625, 272 clinicians

Practice addresses (Care Compare)

1630 Chippewa Dr
Rhinelander, WI 54501-9503
Phone (715) 361-5480

2720 Plaza Dr
Wausau, WI 54401-4166

425 Pine Ridge Blvd
Wausau, WI 54401-4123

5409 Vern Holmes Dr
Stevens Point, WI 54482-8853
Phone (715) 870-2162

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40
Cost
78.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
370WIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Feb 19, 2014 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jul 13, 2009 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin CurrentSince May 29, 2024 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince May 29, 2024 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Feb 19, 2014 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jul 13, 2009 Accepting new patients
Aspirus Medical Group, Inc. Past Accepting new patients
Aspirus Wausau Hospital Inc Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

110 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2351

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

2720 Plaza Dr
Ste 1400
Wausau, WI 54401
Phone (715) 847-2004

2720 Plaza Dr
Ste 1400A
Wausau, WI 54401
Phone (715) 847-0426

425 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2400

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831128669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WESTHILL DR",
            "address_2": "SUITE 303",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 PLAZA DR",
            "address_2": "SUITE 1400",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014158",
            "telephone_number": "715-847-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULICH",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "RD CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.