Individual provider Active NPI

Taylor John Jaraczewski

  • Student in an Organized Health Care Education/Training Program
  • Milwaukee, WI
National Provider Identifier
1932660164
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
8701 Watertown Plank Rd
Department of Surgery, Division of Education
Milwaukee, WI 53226
Phone
(414) 955-1833
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

8701 Watertown Plank Rd
Department of Surgery, Division of Education
Milwaukee, WI 53226

Mailing address

8701 Watertown Plank Rd
Department of Surgery, Division of Education
Milwaukee, WI 53226

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
I20200130000655 WI Order and Referring Only - General SurgeryPractitioner - General Surgery 8628404241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1932660164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 WATERTOWN PLANK RD",
            "address_2": "DEPARTMENT OF SURGERY, DIVISION OF EDUCATION",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 WATERTOWN PLANK RD",
            "address_2": "DEPARTMENT OF SURGERY, DIVISION OF EDUCATION",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-955-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARACZEWSKI",
        "first_name": "TAYLOR",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.