Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jack Avak Tertadian, MD

Individual provider Internal Medicine Physician · NPI 1689780462

Dr. Jack Avak Tertadian, MD is an Internal Medicine in Cudahy, Wisconsin. Graduated from Medical College of Wisconsin in 1990, 36 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
36
Trained at
Medical College of Wisconsin
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5900 S Lake Dr
Cudahy, WI 53110
Phone: (414) 489-4190
Fax: (414) 489-4015
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 34176-020 (WI)

Record details

NPI number1689780462
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 22, 2006
Last updated in NPPESAugust 2, 2024
Certification dateAugust 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 1990 (36 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Cudahy