Individual provider Active NPI

Jessica Lynn Hoffstatter, DPM

  • Podiatrist
  • Grand Blanc, MI
National Provider Identifier
1033786595
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5951001414 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-5000
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5951001414 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

35763 100TH Ave
Stanley, WI 54768-5850
Phone (715) 206-0315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625002945 WI Practitioner - Podiatry 7618378407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Foot and Ankle Clinic LLCGroup PAC ID 3072514876, 8 clinicians

Practice addresses (Care Compare)

100 S Court St
Merrill, WI 54452-2514
Phone (715) 241-8100

140 Wilshire Blvd N
Stevens Point, WI 54481-1360
Phone (715) 241-8100

2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 241-8100

333 Pine Ridge Blvd
Wausau, WI 54401-4102
Phone (715) 241-8100

5403 Normandy St
Weston, WI 54476-2217
Phone (715) 241-8100

570 N Main St
Shawano, WI 54166-1945
Phone (715) 298-5949

737 Dorr St
Antigo, WI 54409-1472
Phone (715) 241-8100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue80
Removal of nail tissue879
Removal or shaving of skin growth293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Foot and Ankle Clinic LLC Podiatrist CurrentSince Jul 1, 2024 Accepting new patients
Family Foot and Ankle Clinic LLC Podiatrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

737 Dorr St
Antigo, WI 54409
Phone (715) 623-4710

100 S Court St
Merrill, WI 54452
Phone (715) 722-0999

570 N Main St
Shawano, WI 54166
Phone (715) 298-5949

140 Wilshire Blvd N
Stevens Point, WI 54481
Phone (715) 341-1266

2400 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2022

5403 Normandy St
Weston, WI 54476
Phone (262) 210-7820

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1033786595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35763 100TH AVE",
            "city": "STANLEY",
            "state": "WI",
            "postal_code": "547685850",
            "telephone_number": "715-206-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFSTATTER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5951001414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.