DR. MARY SUSAN JAY (NPI# 1649221482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649221482 |
| Entity Type | Individual |
| Full Name | DR. MARY SUSAN JAY |
| Credential | MD |
| Practice Address |
8915 W Connell Ave Milwaukee WI 53226-3067 |
| Practice Telephone | 4142662873 |
| Practice Fax Number | 4143377860 |
| Mailing Telephone | 4142662873 |
| Mailing Fax Number | 4143377860 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2019-06-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
47315 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1649221482 | 05 | |
| HUMANA | 000030377M | 01 | |
| WI | 34582200 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6809 122nd Ave, Kenosha, WI 531427335 | 8776075280 | |
| 9000 W Wisconsin Ave, Milwaukee, WI 532264874 | 4142662754 | 4143377860 |
| Street Address |
8915 W CONNELL AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-3067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445788 | Sarah Nettesheim | Registered Nurse | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2020-10-18 |
| 1336747427 | Layal Mahmoud Abou Daher | Anesthesiology | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2020-10-12 |
| 1306458013 | Acacia Louise Newcomb | Nurse Practitioner | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2020-08-24 |
| 1932729118 | Erin Nicole Meincke | Nurse Practitioner | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2020-04-17 |
| 1821627886 | Tracy Jaglinski | Nurse Practitioner | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2020-04-02 |
| 1548898794 | Emily Tomlinson | Student in an Organized Health Care Education/Training Program | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2020-03-31 |
| 1083175772 | Natalya Monet Beneschott | Student in an Organized Health Care Education/Training Program | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2019-03-26 |
| 1538629647 | Kaitlyn Skrzypcak | Student in an Organized Health Care Education/Training Program | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2019-03-24 |
| 1275024820 | Zachary Mark Wadsworth | Anesthesiology | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2018-05-18 |
| 1902302847 | Ashleigh Watson | Pediatrics | 8915 W Connell Ave, Milwaukee, WI 53226-3067 | 2018-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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 |
|---|---|---|---|---|
| 1801154000 | Kathryn E Gannon-loew | Pediatrics | 540 N 16th St, Milwaukee, WI 53233-2160 | 2012-04-25 |
| 1518165380 | Syed N Hasnain | Pediatrics | 1971 W Capitol Dr, Milwaukee, WI 53206-1909 | 2007-07-03 |
| 1629292206 | Thomas Henry Kowalski | Pediatrics | 3872 S Lake Dr Unit 404, Milwaukee, WI 53235-5236 | 2007-04-13 |
| 1396740296 | Najwa A Beit Shawish | Pediatrics | 3003 W Good Hope Rd, Milwaukee, WI 53209-2042 | 2005-06-16 |
| 1770838641 | Alicia E Idler-perez | Pediatrics | 1308 S 16th St, Milwaukee, WI 53204-2711 | 2012-07-17 |
| 1477694818 | Edward James Muellerleile | Pediatrics | 8532 W Capitol Dr, Milwaukee, WI 53222-1827 | 2007-02-09 |
| 1659484020 | Sarah J. Lerand | Pediatrics | 9000 W Wisconsin Ave, Milwaukee, WI 53226-3518 | 2006-08-17 |
| 1770534661 | Wendi Ehrman | Pediatrics | 5433 W Fond Du Lac Ave, Midtown Pediatrics, Milwaukee, WI 53216-1382 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922392067 | Mary Guillot | Pediatrics | 999 N 92nd St Ste 460, Wauwatosa, WI 53226 | 2011-06-07 |
| 1144555178 | Katsumi Neeno | Pediatrics | 2341 Tradition Ln, Janesville, WI 53545-0723 | 2009-10-08 |
| 1588857841 | Leah W Mcavoy | Pediatrics | 5471 W Waterford Ln Ste B, Appleton, WI 54913-8510 | 2007-08-21 |
| 1912929803 | Mary L. Ganz | Pediatrics | 1290 Betsy Ross Ct, Brookfield, WI 53045-5362 | 2006-07-23 |
| 1164463261 | Pradeep Gopi Kumar | Pediatrics | 8348 Washington Ave, Mount Pleasant, WI 53406-3733 | 2006-06-09 |
| 1962478040 | Peter S Karofsky | Pediatrics | 2711 Allen Blvd, Middleton Teen Clinic, Middleton, WI 53562 | 2006-02-27 |
| 1376769794 | Paula J. Cody | Pediatrics | 2880 University Ave, Madison, WI 53705-3644 | 2007-04-17 |
| 1700948502 | Jeri A Nelson | Pediatrics | 1300 South Dr., Winnebago, WI 54985-0009 | 2006-12-15 |
| 1942369269 | Mariano F Deguzman | Pediatrics | 3734 7th Ave, Suite 1, Kenosha, WI 53140 | 2006-12-06 |
| 1194759498 | Margaret M. Hennessy | Pediatrics | 3807 Spring St, Racine, WI 53405-1667 | 2006-07-10 |
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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.