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

Mary Jane De Jesus

Individual provider Registered Nurse · NPI 1194337089

Mary Jane De Jesus is a Nurse Practitioner in Milwaukee, Wisconsin. Qualified in 2019, 7 years ago. Practices with Procare Medical Group SC, a 16-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

3727 W Wisconsin Ave
Milwaukee, WI 53208-3182
Phone: (414) 291-2626
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 934 S 32nd St, Milwaukee, WI 53215-1550 — (414) 519-6888

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10316-33 (WI)
Registered Nurse Taxonomy 163W00000X · Licence 199574-30 (WI)

Record details

NPI number1194337089
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 20, 2020
Last updated in NPPESMarch 29, 2021
Certification dateMarch 29, 2021
Mailing address3727 W Wisconsin Ave, Milwaukee, WI 53208-3182

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Procare Medical Group Sc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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