Individual provider Active NPI

Jamie S Deering, MD

  • Family Medicine Physician
  • Fond Du Lac, WI
National Provider Identifier
1164473617
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41344-020 Issued in WI
Practice address
420 E Division St
Fond Du Lac, WI 54935-4560
Phone
(920) 926-8420
Fax
(920) 926-8907
NPI assigned
May 12, 2006
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41344-020 WI Primary

Addresses

Primary practice location

420 E Division St
Fond Du Lac, WI 54935-4560

Mailing address

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8420

Other identifiers 2

IdentifierTypeStateIssuer
P01510820OtherWIRAILROAD MEDICARE
1164473617MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000397 WI Practitioner - Family Practice 9931121365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

608 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
56.02
Promoting interoperability
100
Improvement activities
40
Cost
72.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41344-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 17, 2020 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Nov 11, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 17, 2020 Accepting new patients
Agnesian Healthcare Inc CurrentSince Nov 11, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc Current Accepting new patients
Agnesian Healthcare Inc Family Medicine Past Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

705 S University Ave
Ste 500
Beaver Dam, WI 53916
Phone (920) 356-9288

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

608 W Brown St
Waupun, WI 53963
Phone (920) 324-6800

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: jamie.deering@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: jdeering261208@direct-ehr-ssmhc.com

Organizations & group practices 8

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1164473617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8420",
            "fax_number": "920-926-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8420",
            "fax_number": "920-926-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEERING",
        "first_name": "JAMIE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "41344-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01510820",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164473617",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.