JARED CONNOLLY
NPI 1790130474
Pediatrics in Greenfield, WI

Q: What is Jared Connolly's NPI number?

The NPI number for Jared Connolly is 1790130474. It was assigned to this individual provider in the NPPES registry on April 29, 2016.

Q: What is Jared Connolly's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jared Connolly was last updated on January 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 29, 2016PECOS Enrolled

9000 W SURA LN, GREENFIELD, WI 53228(414) 246-6800(414) 246-6405 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 30, 2021, Aug 9, 2019, Jul 1, 2019 (3 updates tracked since 2019).

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About Jared Connolly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JARED CONNOLLY (NPI 1790130474) is an individual pediatrics provider in Greenfield, Wisconsin, licensed in Wisconsin (71078) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in River Forest.

NPPES Registry Identity

NPI1790130474

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameJARED CONNOLLY

Location Address9000 W SURA LNGreenfield, WI 53228

Mailing Address9000 W Sura LnGreenfield, WI 53228-3477 · (414) 246-6800 · Fax (414) 246-6405

Phone(414) 246-6800

Fax(414) 246-6405

Sole ProprietorNo

Enumeration DateApril 29, 2016

Last NPPES UpdateJanuary 9, 20243 updates tracked since enumeration

NPPES CertifiedJanuary 9, 2024

✔ NPI 1790130474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in WI · 71078

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

9000 W SURA LN, Greenfield, WI 53228

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Secondary Practice Location 1

Location 1500 Thatcher AveRiver Forest, IL 60305-1625 · Phone (708) 203-4995

Other Identifiers 1

Medicaid100089836WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jared Connolly is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jared Connolly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Aurora Medical Group, Inc.

2.9 mi

Obstetrics & Gynecology

8905 W LINCOLN AVE, SUITE 515
West Allis, WI 53227

Reassigned Medicare billing, Wisconsin enrollment
4,609 clinicians in this Medicare group

NPI 1457592735 (414) 328-8650

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53228 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANEY ANNE BUBLITZ OTR/L

Occupational Therapist