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

Individual provider Critical Care Medicine (Internal Medicine) Physician · NPI 1265775993

Dr. Jason Scott Prudom, MD is a Pulmonary Disease in Milwaukee, Wisconsin. Qualified in 2013, 13 years ago. Practices with Midwest Critical Care SC, a 45-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
13
Licensed in
WI
In the registry since
2013
Specialties on file
2
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

3201 S 16th St Ste 2015
Milwaukee, WI 53215-4532
Phone: (414) 649-3810
Fax: (262) 240-0841
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X · Licence 63600-20 (WI)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence 63600-20 (WI)

Record details

NPI number1265775993
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 1, 2013
Last updated in NPPESMarch 25, 2019
Mailing addressGreater Milwaukee Critical Care And Pulmonary Associate, Po Box 070520, Milwaukee, WI 53207-0520

Medicare enrollment

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

Medicare specialtyPULMONARY DISEASE
Also practisesCRITICAL CARE (INTENSIVISTS)
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Midwest Critical Care Sc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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