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

Jacob Tyler McCallum, DO

Individual provider Diagnostic Radiology Physician · NPI 1194210492

Jacob Tyler McCallum, DO is a Diagnostic Radiology in Middleton, Wisconsin. Qualified in 2018, 8 years ago. Practices with Dean Health Systems Inc, a 1,184-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan and Wisconsin.

Years since qualifying
8
Licensed in
MI, WI
In the registry since
2018
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

8430 Market St Apt 118
Middleton, WI 53562-4782
Phone: (612) 328-1583
Show map & directions

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

Additional practice locations (1)

  • 221 Michigan St Ne Ste 402, Grand Rapids, MI 49503-2538 — (616) 391-1929

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 81114 (WI)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 5101024188 (MI)

Record details

NPI number1194210492
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 28, 2018
Last updated in NPPESJuly 23, 2024
Certification dateJuly 23, 2024
Mailing address8430 Market St Apt 118, Middleton, WI 53562-4782

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Dean Health Systems Inc — 1184 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Middleton