Individual provider Active NPI

Jennifer Wollach Hartlaub, APNP

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1962519579
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
978-033 Issued in WI
Doing business as
Jennifer Wollach Trewyn
Practice address
945 N 12TH St
Milwaukee, WI 53233-1305
Phone
(414) 219-6000
Fax
(414) 385-5113
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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 978-033 WI Primary

Addresses

Primary practice location

945 N 12TH St
Milwaukee, WI 53233-1305

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
43852600MedicaidWI

Other names 1

  • Jennifer Wollach Trewyn Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jhartlaub40134@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20040628000307 WI Practitioner - Nurse Practitioner 5193701472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
978-033WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Metro, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 31, 2020 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 31, 2020 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

945 N 12th St
Ste 102
Milwaukee, WI 53233

1818 W National Ave
Milwaukee, WI 53204
Phone (414) 385-5100

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

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

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

1020 N 12th St
Ste 202
Milwaukee, WI 53233

Organizations & group practices 6

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1962519579",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-6000",
            "fax_number": "414-385-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLAUB",
        "first_name": "JENNIFER",
        "middle_name": "WOLLACH",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "978-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43852600",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhartlaub40134@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1818 W National Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532041118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1818 W National Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532041118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "TREWYN",
            "middle_name": "WOLLACH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.