Individual provider Active NPI

Melissa Jane O'Keefe, PA-C

  • Physician Assistant
  • Hudson, WI
National Provider Identifier
1245664317
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3198-23 Issued in WI
Practice address
2651 Hillcrest Drive
Hudson, WI 54016-4439
Phone
(715) 531-6800
Fax
(715) 531-6801
NPI assigned
Aug 26, 2013
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11403 MN
Physician Assistant 363A00000X 3198-23 WI Primary

Addresses

Primary practice location

2651 Hillcrest Drive
Hudson, WI 54016-4439

Mailing address

2651 Hillcrest Drive
Suite 303
Hudson, WI 54016-4439
Phone (715) 531-6800

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
I20140716002575 WI Practitioner - Physician Assistant 7618102161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Physicians SCGroup PAC ID 2668607557, 62 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Hudson, WI 54016-4439
Phone (715) 531-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11403MNMDPhysician Assistant
3198-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Physicians, S.C CurrentSince Feb 13, 2023 Accepting new patients
Hudson Physicians, S.C. CurrentSince Feb 13, 2023 Accepting new patients
Hudson Physicians, S.C. Past Accepting new patients

Locations

2651 Hillcrest Dr
Hudson, WI 54016
Phone (630) 632-2648

2651 Hillcrest Dr
Ste 303
Hudson, WI 54016

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/42a1ed53-a9ac-42b2-918f-be592f726951/

Organizations & group practices 4

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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1245664317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DRIVE",
            "address_2": "SUITE 303",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DRIVE",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFE",
        "first_name": "MELISSA",
        "middle_name": "JANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11403",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3198-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.