Individual provider Active NPI

Jennifer Vipond, M.D.

  • Pediatrics Physician
  • Waukesha, WI
National Provider Identifier
1851367072
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
32533 Issued in WI
Practice address
N14W23900 Stone Ridge Dr
Prohealth Care Medical Associates Inc.
Waukesha, WI 53188-1135
Phone
(262) 549-3030
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32533 WI Primary

Addresses

Primary practice location

N14W23900 Stone Ridge Dr
Prohealth Care Medical Associates Inc.
Waukesha, WI 53188-1135

Mailing address

N14W23900 Stone Ridge Dr
Prohealth Care Medical Associates Inc.
Waukesha, WI 53188-1135
Phone (262) 549-3030

Other identifiers 1

IdentifierTypeStateIssuer
31714600MedicaidWI

Other names 1

  • Jennifer Hoppe Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120619000238 WI Practitioner - Pediatric Medicine 9133031875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Wisconsin School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

210 NW Barstow St
Suite 201
Waukesha, WI 53188-3771
Phone (262) 555-4869

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32533WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. Pediatrics CurrentSince May 11, 2012 Accepting new patients
Prohealth Medical Group Inc CurrentSince May 11, 2012 Accepting new patients

Locations

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: jvipond10550@direct.phci.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1851367072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N14W23900 STONE RIDGE DR",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881135",
            "telephone_number": "262-549-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23900 STONE RIDGE DR",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881135",
            "telephone_number": "262-549-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIPOND",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "32533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31714600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HOPPE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.