PANKAJ JAIN (NPI# 1033538590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033538590 |
| Entity Type | Individual |
| Full Name | PANKAJ JAIN |
| Practice Address |
1506 S Oneida St Appleton WI 54915-1305 |
| Mailing Address |
1506 S Oneida Street Appleton WI 54915-1305 |
| Practice Telephone | 9207307670 |
| Mailing Telephone | 9207307670 |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
67615 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1033538590 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 130 2nd St, Neenah, WI 549562883 | (920) 969-7900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639784408 | Pankaj Jain | Internal Medicine | 800 Washington St, Boston, MA 02111-1552 | 2020-09-09 |
| 1174941108 | Pankaj Jain | Pediatrics | 1400 S Dobson Rd, Mesa, AZ 85202-4707 | 2014-04-07 |
| 1699017095 | Pankaj Jain | Student in an Organized Health Care Education/Training Program | 300 Community Dr, Manhasset, NY 11030-3816 | 2013-03-23 |
| 1124303557 | Pankaj Jain | Anesthesiology | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2011-10-17 |
| 1689822397 | Pankaj Jain | Anesthesiology | 100 North Academy Ave., Danville, PA 17822-2025 | 2008-09-05 |
| 1215996301 | Pankaj Jain | Internal Medicine | 3800 W 203rd St, Suite 202, Olympia Fields, IL 60461-1184 | 2006-03-20 |
| 1730152422 | Pankaj M Jain | Urology | 13555 W Mcdowell Rd, Suite 203, Goodyear, AZ 85395-2624 | 2006-02-11 |
| Street Address |
1506 S ONEIDA ST |
| City | APPLETON |
| State | WI |
| Zip Code | 54915-1305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205828654 | Gladys Beth Michaelson | Registered Nurse | 1506 S Oneida St, Appleton, WI 54915-1305 | 2005-08-19 |
| 1184249773 | Allison Nierode | Student in an Organized Health Care Education/Training Program | 1506 S Oneida St, Appleton, WI 54915-1305 | 2020-06-10 |
| 1700401429 | Amanda Sue Mansfield | Occupational Therapy Assistant | 1506 S Oneida St, Appleton, WI 54915-1305 | 2020-06-09 |
| 1063044782 | Rebecca Ann Kloehn | Nurse Practitioner | 1506 S Oneida St, Appleton, WI 54915-1305 | 2020-02-11 |
| 1124658422 | Jeremy Scott Wells | Registered Nurse | 1506 S Oneida St, Appleton, WI 54915-1305 | 2020-01-25 |
| 1477104388 | Hitomi Gunsolley | Psychologist | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-09-23 |
| 1861045957 | Brianna M Montano | Counselor | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-07-18 |
| 1902458177 | Kelsey Gregory | Nurse Practitioner | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-07-09 |
| 1700442100 | Maija K West | Occupational Therapist | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-05-13 |
| 1750947263 | Samuel Markert | Nurse Practitioner | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1912426958 | Shanna L. Larsen | Registered Nurse | 1101 E. South River St., Appleton, WI 54915 | 2017-09-11 |
| 1477082816 | Amy Fazel | Driver | 226 E Calumet St, Appleton, WI 54915 | 2017-06-08 |
| 1871940213 | B.a.israel LLC | Community Based Residential Treatment Facility, Mental Illness | N9520 Silver Court, Appleton, WI 54915 | 2016-05-16 |
| 1982933479 | Stephanie I. Braski | Counselor | 1531 S. Oneida St, Appleton, WI 54915 | 2009-12-14 |
| 1386808319 | Shawn S Williamson | Emergency Medicine | 1506 South Oneida Street, Appleton, WI 54915 | 2008-07-18 |
| 1700040870 | Heidi Jo Van Toll | Occupational Therapist | 1335 S Oneida Street, Appleton, WI 54915 | 2008-07-17 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| 1265699748 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Fl 4, Appleton, WI 54915 | 2008-05-21 |
| 1073770558 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Ste 580, Appleton, WI 54915 | 2008-05-21 |
| Find all providers in zip 54915 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003020199 | Fox Valley Neonatology Sc | Pediatrics | 1506 S Oneida St, Appleton, WI 54915-1305 | 2007-05-09 |
| 1962616037 | Howard L Kidd | Pediatrics | 1506 S Oneida St, Appleton, WI 54915-1305 | 2007-05-09 |
| 1427166313 | Cathy Fakler Azzarello | Pediatrics | 1506 S Oneida St, Neonatology, Appleton, WI 54915-1305 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995494 | Emily Niederhauser | Pediatrics | 675 Highland Ave, Madison, WI 53792-0001 | 2019-01-09 |
| 1831455542 | Adam Steven Bauer | Pediatrics | H6 535 Csc Mailbox 4108, 600 Highland Avenue, Madison, WI 53792 | 2012-04-06 |
| 1831361716 | Janissa Kaye Muller | Pediatrics | 3070 N 51st St # P309, Milwaukee, WI 53210-1645 | 2008-03-31 |
| 1073635157 | Robert Michael Rock Jr. | Pediatrics | 835 S. Vanburen St., Green Bay, WI 54301 | 2007-04-06 |
| 1548393671 | Paul R Myers | Pediatrics | 120 2nd St, Chw-fv, Nicu, Neenah, WI 54956-2883 | 2007-03-14 |
| 1881761971 | Stephen Charles Ragatz | Pediatrics | 3070 N 51st St Ste 309, Suite 309, Milwaukee, WI 53210-1661 | 2006-11-30 |
| 1639264187 | Kyle Owen Mounts | Pediatrics | 3070 North 51st St., Suite P309, Milwaukee, WI 53210-1661 | 2006-10-03 |
| 1427166214 | Ash Mehra | Pediatrics | 635 N 35th St, Milwaukee, WI 53208-3872 | 2006-08-29 |
| 1255448817 | Sahar Katib Kayata | Pediatrics | 3070n.51 St, Ste 309, Milwaukee, WI 53210 | 2006-08-23 |
| 1174639546 | Kevin Eugene Halbert | Pediatrics | 3070 N. 51st Street, Suite P309, Milwaukee, WI 53210-1661 | 2006-08-21 |
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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.