Individual provider Active NPI

Jenny L. Martin, ACNP

  • Nurse Practitioner
  • St Francis, WI
National Provider Identifier
1871825323
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3955-33 Issued in WI
Practice address
2000 E Layton Ave
St Francis, WI 53235-6053
Phone
(414) 744-7880
NPI assigned
Feb 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3955-33 WI Primary

Addresses

Primary practice location

2000 E Layton Ave
St Francis, WI 53235-6053

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

701 S Church St
Watertown, WI 53094-6213
Phone (920) 262-4720

Other practice location 2

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2955

Other identifiers 2

IdentifierTypeStateIssuer
3955-33OtherWILICENSE NUMBER
10007821MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address jmartin230472@direct.myadvocateaurora.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000605 WI Practitioner - Nurse Practitioner 1850435678 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

14555 W National Ave
Suite 140
New Berlin, WI 53151-4483
Phone (414) 649-1280

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jul 8, 2019 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jul 8, 2019 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jul 8, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 8, 2019 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jul 8, 2019 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince Jul 8, 2019 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

9200 W Loomis Rd
Franklin, WI 53132
Phone (414) 529-9200

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

14555 W National Ave
Ste 140
New Berlin, WI 53151
Phone (262) 827-0480

200 E Ryan Rd
Oak Creek, WI 53154
Phone (414) 570-3590

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

1284 N Summit Ave
Summit, WI 53066
Phone (262) 560-3700

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000

6609 W Greenfield Ave
West Allis, WI 53214
Phone (414) 257-8500

Organizations & group practices 8

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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1871825323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAYTON AVE",
            "city": "ST FRANCIS",
            "state": "WI",
            "postal_code": "532356053",
            "telephone_number": "414-744-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 S Church St",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "WI",
            "postal_code": "530946213",
            "country_code": "US",
            "telephone_number": "920-262-4720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14555 W National Ave",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "53151",
            "country_code": "US",
            "telephone_number": "262-827-2955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNY",
        "middle_name": "L.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3955-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "3955-33",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10007821",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "14555 W National Ave",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmartin230472@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "14555 W National Ave",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Francis, WI

Sources for this page

Verify at the official NPI Registry.