Individual provider Active NPI

Jon L Woolever, M.D.

  • Family Medicine Physician
  • Mukwonago, WI
National Provider Identifier
1982677969
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43670 Issued in WI
Practice address
240 Maple Ave
Prohealth Care Medical Associates Inc
Mukwonago, WI 53149-8475
Phone
(262) 928-1900
Fax
(262) 363-1949
NPI assigned
Feb 9, 2006
Last updated
Dec 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43670 WI Primary

Addresses

Primary practice location

240 Maple Ave
Prohealth Care Medical Associates Inc
Mukwonago, WI 53149-8475

Mailing address

N17W24100 Riverwood Dr
Suite 250
Waukesha, WI 53188-1177
Phone (262) 928-4100

Other identifiers 1

IdentifierTypeStateIssuer
34151700MedicaidWI

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
I20100515000028 WI Practitioner - Family Practice 3971631763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

13900 W National Ave
New Berlin, WI 53151-9515
Phone (262) 928-4500

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900

721 American Ave
Waukesha, WI 53188-5071

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-1000

790 Cornerstone Xing
Waterford, WI 53185-4582
Phone (262) 363-1977

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43670WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. Family Medicine CurrentSince Aug 7, 2011 Accepting new patients
Prohealth Medical Group Inc Family Medicine Past Accepting new patients

Locations

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

400 Bay View Rd
Mukwonago, WI 53149
Phone (262) 363-1900

240 Maple Ave
Ste 100
Mukwonago, WI 53149

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

808 Cornerstone Xing
Waterford, WI 53185
Phone (262) 500-5292

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Ste 250
Waukesha, WI 53188

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: jwoolever547@direct.phci.org

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1982677969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N17W24100 RIVERWOOD DR",
            "address_2": "SUITE 250",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881177",
            "telephone_number": "262-928-4100",
            "fax_number": "262-928-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MAPLE AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498475",
            "telephone_number": "262-928-1900",
            "fax_number": "262-363-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLEVER",
        "first_name": "JON",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "43670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34151700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukwonago, WI

Sources for this page

Verify at the official NPI Registry.