Individual provider Active NPI

Mary A Jadin, NP

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1164379152
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18178-33 Issued in WI
Practice address
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone
(920) 433-6000
NPI assigned
Mar 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18178-33 WI Primary

Addresses

Primary practice location

1630 Commanche Ave
Green Bay, WI 54313-5753

Mailing address

3187 Trinity CT
De Pere, WI 54115-2785
Phone (920) 655-3069

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260406001037 WI Practitioner - Nurse Practitioner 3577038843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4700

2015 Shawano Ave
Green Bay, WI 54303-2606
Phone (920) 592-9478

2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505

3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700

744 S Webster Ave
Green Bay, WI 54301-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18178-33WIMDFamily Nurse Practitioner

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": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1164379152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3187 TRINITY CT",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541152785",
            "telephone_number": "920-655-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 COMMANCHE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135753",
            "telephone_number": "920-433-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADIN",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "18178-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.