Individual provider Active NPI

Jessica L Juntunen, MD

  • Sports Medicine (Family Medicine) Physician
  • Wausau, WI
National Provider Identifier
1902166978
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
70079-20 Issued in WI
Practice address
225000 Hummingbird Rd Ste 100
Wausau, WI 54401-2950
Phone
(715) 359-6442
Fax
(715) 393-0390
NPI assigned
May 23, 2012
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 50450 AZ
Sports Medicine (Family Medicine) Physician 207QS0010X 70079-20 WI Primary

Addresses

Primary practice location

225000 Hummingbird Rd Ste 100
Wausau, WI 54401-2950

Mailing address

225000 Hummingbird Rd Ste 100
Wausau, WI 54401-2950
Phone (715) 359-6442

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
I20190111002275 WI Practitioner - Family Practice 7113244922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bone and Joint Clinic S.C.Group PAC ID 3678541919, 45 clinicians

Practice addresses (Care Compare)

225000 Hummingbird Rd
Suite 100
Wausau, WI 54401-2950
Phone (715) 359-6442

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50450AZMDSports Medicine (Family Medicine) Physician
70079-20WIMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bone & Joint Clinic S.C. CurrentSince Dec 3, 2018 Accepting new patients
Bone & Joint Clinic S.C. CurrentSince Dec 3, 2018 Accepting new patients

Locations

724 S 8th St
Medford, WI 54451
Phone (715) 748-2663

100 S Eagle Dr
Merrill, WI 54452
Phone (715) 358-1911

1767 Park Ave
#100
Plover, WI 54467
Phone (715) 344-1260

225000 Hummingbird Rd
Ste 100
Rib Mountain, WI 54401
Phone (715) 359-3442

225000 Hummingbird Rd
Ste 300
Rib Mountain, WI 54401
Phone (715) 359-7592

400 Westwood Dr
#100
Wausau, WI 54401
Phone (715) 393-0372

400 Westwood Dr
#200
Wausau, WI 54401
Phone (715) 261-0425

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1902166978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225000 HUMMINGBIRD RD STE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012950",
            "telephone_number": "715-359-6442",
            "fax_number": "715-393-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225000 HUMMINGBIRD RD STE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012950",
            "telephone_number": "715-359-6442",
            "fax_number": "715-393-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNTUNEN",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "50450",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "70079-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.