Individual provider Active NPI

Jocelyn Marie Seppala, PA

  • Physician Assistant
  • Mequon, WI
National Provider Identifier
1174113179
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078
Phone
(262) 292-3151
NPI assigned
Jan 22, 2021
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078

Mailing address

10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078
Phone (262) 292-3151

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
I20210723002569 WI Practitioner - Physician Assistant 1355744657 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Radiology Wisconsin LLCGroup PAC ID 9537595533, 111 clinicians

Practice addresses (Care Compare)

10180 Washington Ave
Mount Pleasant, WI 53177-1604
Phone (414) 973-7830

3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4011

3807 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-8300

3811 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical X-Ray Consultants, LTD Physician Assistant CurrentSince Sep 26, 2025 Accepting new patients
Premier Radiology Wisconsin, LLC CurrentSince Jan 10, 2025 Accepting new patients
Precision Radiology - Illinois LTD Past Accepting new patients
Medical Xray Consultants, LTD PastSince May 16, 2021 Accepting new patients

Locations

900 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 717-4121

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

Organizations & group practices 5

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 4

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": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1174113179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD STE 201",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925078",
            "telephone_number": "262-292-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD STE 201",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925078",
            "telephone_number": "262-292-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPPALA",
        "first_name": "JOCELYN",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.