Jennifer K Gagnon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16115 Issued in WI

Practice address

5818 W Capitol Dr
Milwaukee, WI 53216-2247

Phone

(414) 449-2114

NPI assigned

Sep 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

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)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment Care Compare group NPD
• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1003861188

  Physical Therapist

  Medicare reassignment NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Eyas Landing, Inc.

  • Early Intervention Provider Agency
  • Chicago, IL
  • NPI 1053621391
  NPD (past)

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1992475321",
    "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": "414-449-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162247",
            "telephone_number": "414-449-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.026066",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230064",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmillisor357028@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1409 W Carroll Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606071105",
            "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": "1409 W Carroll Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606071105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Susan Gage, LPC
• Karen Sue Gage, M.S.W., C.I.S.W.
• Pamela Gage, APNP, ACCNS-P, CPN
• Nunzio A. Gaglianello, M.D.
• Sarah M Gaglianello, MD
• Mary Beryl Gagnon, B.A.
• Shobha D Gagrat, MD
• Katlyn Gahan
• Thomas A Gahl, MD
• Nicole T. Gail

• Physical Therapist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.