Jared L Stahlecker, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

64449-20 Issued in WI

Practice address

849 Kellogg Ave
Janesville, WI 53546-2808

Phone

(608) 755-7960

Fax

(608) 755-7873

NPI assigned

Aug 27, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Family Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartsville Medical Group LLCGroup PAC ID 7012062714, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolina Pines Regional Medical Center Hospital, Hartsville, SC, CCN 420010
• Mercy Health System Corp Hospital, Janesville, WI, CCN 520066

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jstahlecker28055@direct.mhemail.org
• FHIR API: https://api.platform.athenahealth.com/8689/brand/1/csg/1/fhir/r4
• Direct secure messaging: jared.stahlecker.1@8689.direct.athenahealth.com

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.

• Hartsville Medical Group LLC

  • Internal Medicine Physician
  • Hartsville, SC
  • NPI 1598995300

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD
• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD
• Mercy Health System Corporation

  • Prosthetic/Orthotic Supplier
  • Lake Geneva, WI
  • NPI 1710124698
  NPD (past)
• Hartsville, LLC

  • General Acute Care Hospital
  • Hartsville, SC
  • NPI 1174500458
  NPD (past)

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

• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  Care Compare affiliation
• Hartsville, LLC

  • General Acute Care Hospital
  • Hartsville, SC
  • NPI 1174500458
  Care Compare affiliation

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255708129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 KELLOGG AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462808",
            "telephone_number": "608-755-7960",
            "fax_number": "608-755-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 KELLOGG AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462808",
            "telephone_number": "608-755-7960",
            "fax_number": "608-755-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHLECKER",
        "first_name": "JARED",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "64449-20",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "64449-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "STAHLJAR",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWI",
            "identifier": "1255708129",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MEDICARE",
            "identifier": "000054176-K400239660",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255708129",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SSM Health Care of Wisconsin, Inc.
• St Mary'S Dean Ventures Inc
• Jayme St. John
• John C Stagg, D.C.
• Michelle Stahl, APNP-CNP
• Ashton G. Stair, OT
• Sharon L. Stake, MD
• Christopher G Stanek, OT
• Jordan Stanek, APRN
• Heather Stark, MS, SAC-IT

• Family Medicine Physician in Janesville, WI
• Providers in Janesville, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.