Jacqueline M Kaufman, AGPCNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

7839-33 Issued in WI

Practice address

744 S Webster Ave
Green Bay, WI 54301-3505

Phone

(920) 433-3640

Fax

(920) 433-3716

NPI assigned

Apr 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Jacqueline M Craig Former name

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
• Door County Medical Center Hospital, Sturgeon Bay, WI, CCN 521358

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkaufman925473@direct.emplifyhealth.org
• Direct secure messaging: jcraig185016@direct.thedacare.org

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment Care Compare group NPD
• Oconto Hospital & Medical Center Inc

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302
  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Kewaunee, WI
  • NPI 1699737379
  NPD
• Oconto Hospital & Medical Center Inc

  • Rural Health Clinic/Center
  • Suring, WI
  • NPI 1104418037
  NPD
• Oconto Hospital & Medical Center, Inc.

  • Rural Health Clinic/Center
  • Oconto, WI
  • NPI 1609018589
  NPD

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

• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare affiliation
• Door County Memorial Hospital

  • Critical Access Hospital
  • Sturgeon Bay, WI
  • NPI 1093743874
  Care Compare affiliation
• Door County Memorial Hospital

  • Clinical Medical Laboratory
  • Sturgeon Bay, WI
  • NPI 1811090285

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1861926396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3640",
            "fax_number": "920-433-3716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Arbutus Ave",
            "address_purpose": "LOCATION",
            "city": "Oconto",
            "state": "WI",
            "postal_code": "541532004",
            "country_code": "US",
            "telephone_number": "920-835-1100",
            "fax_number": "920-835-1099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433834",
            "country_code": "US",
            "telephone_number": "715-735-5225",
            "fax_number": "715-735-5388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "232951-30",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MI",
            "license": "4704297325",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "7839-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7839-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "CRAIG",
            "middle_name": "M",
            "credential": "AGPCNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jesse C Kaster, BC HIS
• Karen Kaster, APNP
• Kathleen Bahler & Associates, Inc.
• Abigail Lynn Kaufman, DPT
• David K Kaufman, MD
• Ruth Kaufman, M.S., LPC
• Kendra Kaul
• Andrew D Kausak, D-PT
• Tanya V Kavicky-Mels, MFT
• Katie Ralene Kavicky, ND

• Nurse Practitioner in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.