JENNIFER BLEAK (MD) – Psychiatry Physician, NPI 1013124239
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JENNIFER BLEAK (MD)
BELOIT HEALTH SYSTEM COUNSELLING CARE CENTER
1969 W. HART RD
BELOIT, WI 535112230
Phone: (608) 364-5689
Fax: (608) 364-5525
Type: Location
Valley Road, Oconomowoc, Waukesha County, Wisconsin, United States
OCONOMOWOC, WI 530664500
Phone: (262) 354-5877
Fax: (608) 238-4412
Type: Mailing
Habanero's Mexican Kitchen, 3900, West Brown Deer Road, Brown Deer, Milwaukee County, Wisconsin, 53209, United States
SUITE 200
BROWN DEER, WI 532091220
Phone: (414) 540-2170
Fax: (414) 540-2171
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-07-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130715000611 | I | Psychiatry | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 53511)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | WI | 90792 | Psychiatric diagnostic evaluation with medical services | 45 | 44 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI | |
| Family Practice | WI | |
| Family Practice | WI | |
| Family Practice | WI | |
| Nurse Practitioner | WI | |
| Infectious Disease | WI | |
| Internal Medicine | NY | |
| Family Practice | WI |
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