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DR. BRIAN JAY JELLISON MD NPI 1225016835


NPI Information

NPI: 1225016835
Provider Name: DR. BRIAN JAY JELLISON, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
9200 W WISCONSIN AVE
MILWAUKEE, WI
ZIP 53226
Phone: (414) 805-2060
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DR. Brian Jay Jellison, MD is a diagnostic radiology radiology in Milwaukee, WI with 24 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Brian Jay Jellison, MD NPI is 1225016835. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2000

The provider's business location address is:

9200 W WISCONSIN AVE
MILWAUKEE, WI
ZIP 53226-522
Phone: (414) 805-2060
Fax: (414) 259-9290

The NPI 1225016835 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ct scan head or brain (HCPCS:70450)
  • Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
  • Ct scan of face (HCPCS:70486)

The enumeration date for this NPI number is 1/4/2006 and was last updated on 3/31/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic Radiology223452MASSACHUSETTSNo
22085R0202XRadiologyDiagnostic Radiology01061964AINDIANANo
32085R0202XRadiologyDiagnostic RadiologyMD2008-0142NEW MEXICONo
42085R0202XRadiologyDiagnostic Radiology46406WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000000393004OTHERINDIANAANTHEM-352047427
21225016835MEDICAIDWISCONSIN
32101688MEDICAIDMASSACHUSETTS
4P00331579OTHERINDIANARR MEDICARE-351158723
5073863OTHERINDIANASIHO-351158723
6000000492351OTHERINDIANAANTHEM 203778927
7468500OTHERMASSACHUSETTSTUFTS HEALTH PLAN
8J28632OTHERMASSACHUSETTSBCBS OF MA
9000000393001OTHERINDIANAANTHEM-351158723
10073867OTHERINDIANASIHO-352047427
11200828930MEDICAIDINDIANA
1292753337MEDICAIDNEW MEXICO
13Q0433404OTHERINDIANASHOCMO351158723-352047427

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.