| Jodi L Brehm, MD | |
|
10400 75th St, Kenosha, WI 53142 | |
| (262) 648-5600 | |
| (262) 948-5735 |
| Full Name | Jodi L Brehm |
|---|---|
| Gender | Female |
| Speciality | Surgical Oncology |
| Experience | 24 Years |
| Location | 10400 75th St, Kenosha, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649216045 | NPI | - | NPPES |
| 036112238 | Medicaid | IL | |
| 35354900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 036112238 (Illinois) | Secondary |
| 208600000X | Surgery | 52096 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
| Aurora Memorial Hospital Burlington | Burlington, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Mailing Address | Practice Location Address |
|---|---|
| Jodi L Brehm, MD 10400 75th St, Kenosha, WI 53142-7884 Ph: (262) 648-5600 | Jodi L Brehm, MD 10400 75th St, Kenosha, WI 53142 Ph: (262) 648-5600 |
Dr. Mustafa Syed Badrudduja, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 6308 8th Ave, Suite 3050, Kenosha, WI 53143 Phone: 262-654-7002 Fax: 262-654-6822 | |
Dr. Roger Thomas Pacanowski, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-8217 |