NPIMap

Individual provider Active NPI

Kathryn M Jacobe, MD

  • Family Medicine Physician
  • Appleton, WI
National Provider Identifier
1841459815
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53895 Issued in WI
Practice address
229 S Morrison St
Appleton, WI 54911-5725
Phone
(920) 832-2783
Fax
(920) 832-2635
NPI assigned
Jun 5, 2008
Last updated
Apr 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53895 WI Primary

Addresses

Primary practice location

229 S Morrison St
Appleton, WI 54911-5725

Mailing address

229 S Morrison St
Fox Valley Family Medicine
Appleton, WI 54911-5725
Phone (920) 832-2783

Other identifiers 1

IdentifierTypeStateIssuer
1841459815MedicaidWI

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
I20110811000593 WI Practitioner - Family Practice 8325217185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Family Health IncGroup PAC ID 4082925243, 14 clinicians

Practice addresses (Care Compare)

229 S Morrison St
Appleton, WI 54911-5725
Phone (920) 832-2783

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.06 of 100Reported as group
Quality
84.62
Improvement activities
40
Cost
77.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53895WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Family Health, Inc Family Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

100 N Oneida St
Appleton, WI 54911
Phone (920) 832-2783

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

229 S Morrison St
Appleton, WI 54911
Phone (920) 832-2783

2915 N Meade St
Appleton, WI 54911
Phone (920) 831-8700

3300 W Brewster St
Appleton, WI 54914
Phone (920) 832-1657

316 E 14th St
Kaukauna, WI 54130
Phone (920) 766-6020

Organizations & group practices 1

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1841459815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 S MORRISON ST",
            "address_2": "FOX VALLEY FAMILY MEDICINE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115725",
            "telephone_number": "920-832-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S MORRISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115725",
            "telephone_number": "920-832-2783",
            "fax_number": "920-832-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBE",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "53895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841459815",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.