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

Dr. Jack Avak Tertadian, MD

Individual provider Internal Medicine Physician · NPI 1689780462

Dr. Jack Avak Tertadian, MD practises 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
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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

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients140
Services billed 622 a service is one billed item, such as a visit, a test or a procedure
Average patient age77

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

  • Aurora St Lukes Medical Center Hospital · Milwaukee, WI · listed as Aurora St Luke's Medical Center
  • West Allis Memorial Hospital Hospital · West Allis, WI · listed as West Allis Memorial Hospital, Inc
  • Aurora At Home Home health agency · Milwaukee, WI
  • Aurora At Home Hospice · Wauwatosa, WI

Colleagues at Lakeshore Medical Clinic LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 379 clinicians in the practice; 12 are shown here.

Other providers in Cudahy