KENNETH F. JENSEN JR. (NPI# 1003841784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003841784 |
| Entity Type | Individual |
| Full Name | KENNETH F. JENSEN JR. |
| Credential | M.D. |
| Practice Address |
1777 W Grand Ave Port Washington WI 53074-2077 |
| Mailing Address |
3003 W Good Hope Rd Milwaukee WI 53209-2042 |
| Practice Telephone | 2622843456 |
| Practice Fax Number | 2622844543 |
| Mailing Telephone | 4143523100 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2010-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 21735 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | RR MEDICARE | P00449578 | 01 |
| WI | 30317300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831492503 | Kenneth Andrew Jensen | Behavioral Analyst | 7978 24th Ave N, St Petersburg, FL 33710-3737 | 2010-12-17 |
| 1114351665 | Kenneth Dean Jensen | Chiropractor | 533 S Middleton Rd, Suite 102, Middleton, ID 83644-6013 | 2013-09-01 |
| 1467543694 | Kenneth John Jensen | Orthopaedic Surgery | 12 Camino Encinas, Suite 10, Orinda, CA 94563-3395 | 2006-09-26 |
| 1588671200 | Kenneth N Jensen | Nurse Anesthetist, Certified Registered | 400 N Pleasant, Centralia, IL 62801 | 2006-08-02 |
| Street Address |
1777 W GRAND AVE |
| City | PORT WASHINGTON |
| State | WI |
| Zip Code | 53074-2077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356332464 | Dawn M Zak | Counselor | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2005-10-31 |
| 1548791585 | Cameron Blegen | Family Medicine | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2017-03-22 |
| 1932565868 | Aurora Health Care Ventures Inc. | Eyewear Supplier (Equipment, not the service) | 1777 W Grand Ave, Suite 103, Port Washington, WI 53074-2077 | 2016-01-07 |
| 1699130732 | Rhiannon Jauer | Psychologist | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2015-12-16 |
| 1669855656 | Anjuli Marie Tuscano | Physician Assistant | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2015-07-08 |
| 1417247313 | Heidi S Wheeler | Nurse Practitioner | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2011-04-12 |
| 1427246370 | Aurora Advanced Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2007-10-04 |
| 1730376617 | Aurora Advanced Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2007-09-25 |
| 1952508400 | Keith J Hacker | Physician Assistant | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2007-06-28 |
| 1558446971 | Advanced Healthcare, S.c. | Clinical Medical Laboratory | 1777 W Grand Ave, Port Washington, WI 53074-2077 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962045864 | Heather Kay Brede | Technician | 857 Ashley Avenue, Port Washington, WI 53074 | 2019-10-23 |
| 1780062034 | Amanda Zitzer | Specialist/Technologist | 1037 S Spring Street, Apt 257, Port Washington, WI 53074 | 2015-05-07 |
| 1639507643 | Kelly Mulder | Occupational Therapy Assistant | 138 E Prospect St, Port Washington, WI 53074 | 2013-10-30 |
| 1235310921 | Susan Ann Dobberpuhl | Occupational Therapist | 306 N Sprint St, Port Washington, WI 53074 | 2007-11-21 |
| 1245444736 | Lee B Raffel | Social Worker | 3632 E Norport Drive, Port Washington, WI 53074 | 2007-05-10 |
| 1023143708 | Joshua E Leute | Dentist | 1317 West Grand Avenue, Port Washington, WI 53074 | 2007-02-22 |
| 1578633806 | Robert Andrew Kortsch | Dentist | 457 W Grand Ave, Port Washington, WI 53074 | 2006-11-08 |
| 1538256409 | Daniel P Witkowski | Dentist | 1612 N Wisconsin St, Port Washington, WI 53074 | 2006-10-10 |
| 1477584878 | Francine L Cosner | Obstetrics & Gynecology | 1777 W Grand Avenue, Port Washington, WI 53074 | 2006-07-05 |
| 1013953926 | Port Washington Podiatry Inc | Podiatrist | 1317 W Grand Avenue, Port Washington Podiatry, Port Washington, WI 53074 | 2006-06-20 |
| Find all providers in zip 53074 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841539541 | Hemant Kade | Internal Medicine | 27 Driftwood Dr, Port Washington, NY 11050-1716 | 2013-01-31 |
| 1780921262 | William R. Cunnick Jr. | Internal Medicine | 3 Orchard Farm Rd, Port Washington, NY 11050-3309 | 2013-01-03 |
| 1144480799 | Lawrence Blumenkrantz | Internal Medicine | 31 W Shore Rd., Port Washington, NY 11050 | 2008-06-16 |
| 1629198007 | Celestino M. Perez Md Sc | Internal Medicine | 126 E Pier Street, Port Washington, WI 53074-0006 | 2007-03-30 |
| 1245314475 | William Stiling Knight | Internal Medicine | 535 Port Washington Blvd, Suite 201, Port Washington, NY 11050-4217 | 2006-10-24 |
| 1669451613 | Celestino M Perez | Internal Medicine | 126 E Pier St, Box 6, Port Washington, WI 53074-0006 | 2006-01-10 |
| 1396085940 | Johnson Ling | Internal Medicine | 232 Main Street, #2ya, Port Washington, NY 11050 | 2013-02-19 |
| 1972885101 | Frank Raymond Jr. | Internal Medicine | 372 Main St, #206, Port Washington, NY 11050-3132 | 2011-09-14 |
| 1548430366 | Revere Medical Associates, P.C. | Internal Medicine | 535 Port Washington Blvd, Port Washington, NY 11050-4227 | 2008-03-07 |
| 1902980139 | Emia Chan | Internal Medicine | 535 Port Washington Blvd, Suite 201, Port Washington, NY 11050-4217 | 2006-10-24 |
| Find all providers in PORT WASHINGTON | ||||
| City | PORT WASHINGTON |
| Zip Code | 53074 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.