| Jared M Kohlenberg, DO | |
|
670 County Road A, Green Lake, WI 54941-8608 | |
| (920) 294-0100 | |
| (920) 294-0123 |
| Full Name | Jared M Kohlenberg |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 17 Years |
| Location | 670 County Road A, Green Lake, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548498298 | NPI | - | NPPES |
| 1548498298 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 57315-21 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Thedacare At Home | Appleton, WI | Home health agency |
| St Agnes Hsptl Hospice Hope | Fond du lac, WI | Hospice |
| Thedacare At Home | Appleton, WI | Hospice |
| Thedacare Regional Med Ctr - Neenah | Neenah, WI | Hospital |
| Berlin Memorial Hospital | Berlin, WI | Hospital |
| Thedacare Regional Medical Center - Appleton Inc | Appleton, WI | Hospital |
| Ripon Medical Center | Ripon, WI | Hospital |
| Thedacare Medical Center - Wild Rose | Wild rose, WI | Hospital |
| Markesan Resident Home | Markesan, WI | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Thedacare Incorporated | 1759294887 | 533 |
| Entity Name | Thedacare Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376656959 PECOS PAC ID: 1759294887 Enrollment ID: O20031106000088 |
| Entity Name | Thedacare Medical Center - Berlin, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760413777 PECOS PAC ID: 0446151666 Enrollment ID: O20040120000214 |
| Mailing Address | Practice Location Address |
|---|---|
| Jared M Kohlenberg, DO 670 County Road A, Green Lake, WI 54941-8608 Ph: (920) 294-0100 | Jared M Kohlenberg, DO 670 County Road A, Green Lake, WI 54941-8608 Ph: (920) 294-0100 |
Courtney Mcclintic, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 670 County Road A, Green Lake, WI 54941 Phone: 920-294-0100 Fax: 920-294-0123 | |
Dr. Thomas Rice Willett, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: N6205 Busse Rd, Green Lake, WI 54941 Phone: 920-294-3444 Fax: 920-294-6660 |