Jeffrey D Wallach (NPI# 1588638118, PAC ID# 8527977222) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1588638118 |
| PAC ID by PECOS | 8527977222 |
| Professional Enrollment ID | I20100331001187 |
| Full Name | Jeffrey D Wallach |
| Organization Legal Name | MILWAUKEE NEPHROLOGISTS SC |
| Address |
5650 N Green Bay Ave Suite 100 Glendale WI 53209-4447 |
| Phone Number | 4144315971 |
| Gender | M |
| Medical School | UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE |
| Graduation Year | 1975 |
| Primary Specialty | NEPHROLOGY |
| Group Practice PAC ID | 4385538446 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520051 | COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE |
| 520027 | COLUMBIA ST MARYS HOSPITAL OZAUKEE |
| 520136 | WHEATON FRANCISCAN ST JOSEPH |
| Address | Phone | Organization |
|---|---|---|
| 5650 N Green Bay Ave, Suite 100, Glendale, WI 53209-4447 | 4144315971 | MILWAUKEE NEPHROLOGISTS SC |
| Organization Legal Name | MILWAUKEE NEPHROLOGISTS SC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin P Tucker | Nephrology | Milwaukee Nephrologists Sc | 2901 W Kk River Pkwy, Suite 405, Milwaukee, WI 53215-3660 |
| Andrew J Olafsson | Nephrology | Milwaukee Nephrologists Sc | 601 N 99th St, Suite 302, Wauwatosa, WI 53226-4362 |
| Stephen G Sievers | Nephrology | Milwaukee Nephrologists Sc | N54w6135 Mill St, Suite 600, Cedarburg, WI 53012-2064 |
| Robert C Zilke | Nurse Practitioner | Milwaukee Nephrologists Sc | 2901 W Kk River Pkwy, Suite 405, Milwaukee, WI 53215-3660 |
| Manohar Ahuja | Nephrology | Milwaukee Nephrologists Sc | 2901 W Kk River Pkwy, Suite 405, Milwaukee, WI 53215-3660 |
| Adam James Conlin | Nurse Practitioner | Milwaukee Nephrologists Sc | 2901 W Kk River Pkwy, Suite 405, Milwaukee, WI 53215-3660 |
| Janine M Lapp | Nurse Practitioner | Milwaukee Nephrologists Sc | 5650 N Green Bay Ave, Suite 100, Glendale, WI 53209-4447 |
| Ahmed M Malik | Nephrology | Milwaukee Nephrologists Sc | 2901 W Kk River Pkwy, Suite 405, Milwaukee, WI 53215-3660 |
| Jessica F Goelz | Nurse Practitioner | Milwaukee Nephrologists Sc | 2901 W Kk River Pkwy, Suite 405, Milwaukee, WI 53215-3660 |
| Chelsea Rae Derocha-cavalea | Nephrology | Milwaukee Nephrologists Sc | 2901 W Kk River Pkwy, Suite 405, Milwaukee, WI 53215-3660 |
| Street Address |
5650 N GREEN BAY AVE SUITE 100 |
| City | GLENDALE |
| State | WI |
| Zip | 53209-4447 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Janine M Lapp | Nurse Practitioner | Milwaukee Nephrologists Sc | 5650 N Green Bay Ave, Suite 100, Glendale, WI 53209-4447 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia E Noonan | Clinical Nurse Specialist | Columbia St. Mary's Hospital Milwaukee, Inc | 9233 N Green Bay Rd, Brown Deer, WI 53209-1103 |
| Galina Bakman | Nurse Practitioner | Columbia St. Mary's Hospital Milwaukee, Inc | 9233 N Green Bay Rd, Brown Deer, WI 53209-1103 |
| Yuliy M Pershman | Physical Medicine and Rehabilitation | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 |
| Barry K Gimbel | Cardiovascular Disease (cardiology) | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Sean P Ronayne | Family Medicine | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Marina L Kropp | Physical Medicine and Rehabilitation | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Kelly A Richards | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Robert Michael Kitsis | Family Medicine | Columbia St. Mary's Hospital Milwaukee, Inc | 9252 N Green Bay Rd, Fl 2, Brown Deer, WI 53209-1104 |
| Heather M Wells-holtey | Dermatology | Columbia St. Mary's Hospital Milwaukee, Inc | 9252 N Green Bay Rd, Fl 2, Brown Deer, WI 53209-1104 |
| Shannon S Muderlak | Family Medicine | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Find all physicians in zip 53209 | |||
| City | GLENDALE |
| Zip Code | 53209 |
| Specialty | NEPHROLOGY |
| City + Specialty | GLENDALE + NEPHROLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.