Individual provider Active NPI

Melissa L Pierick, PA-C

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1255886453
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3847-23 Issued in WI
Practice address
700 S Park St Ste a
Madison, WI 53715-1830
Phone
(608) 260-2900
Fax
(608) 260-2956
NPI assigned
Aug 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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 3847-23 WI Primary

Addresses

Primary practice location

700 S Park St Ste a
Madison, WI 53715-1830

Mailing address

700 S Park St Ste a
Madison, WI 53715-1830
Phone (608) 260-2900

Other identifiers 1

IdentifierTypeStateIssuer
1255886453MedicaidWI

Other names 1

  • Melissa M Lajeunesse Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address mpierick260660@direct-ehr-ssmhc.com Direct

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
I20161031001468 WI Practitioner - Physician Assistant 6709164445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

1305 W Main St
Whitewater, WI 53190-1503
Phone (262) 473-4548

1310 Broadway
Wisconsin Dells, WI 53965-1358
Phone (608) 253-1171

1821 S Stoughton Rd
Madison, WI 53716-2257
Phone (608) 260-6000

225 Church St
Stoughton, WI 53589-1801
Phone (608) 877-2777

2805 Hunters TRL
Portage, WI 53901-3429
Phone (608) 745-5900

2825 Hunters TRL
Portage, WI 53901-3429
Phone (608) 742-5522

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

740 Reena Ave
Fort Atkinson, WI 53538-3145
Phone (920) 563-0888

752 N High Point Rd
Madison, WI 53717-2236
Phone (608) 824-4000

800 Compassion Way
Dodgeville, WI 53533-1956
Phone (608) 937-7000

833 S Iowa St
Suite 102
Dodgeville, WI 53533-1900
Phone (608) 935-3301

Hospital & facility affiliations

  • SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
  • Upland Hills Health Hospital, Dodgeville, WI, CCN 521352
  • SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057
  • SSM Health St Mary'S Hospital - Janesville Hospital, Janesville, WI, CCN 520208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3847-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Oct 27, 2016 Accepting new patients
Dean Health Systems, Inc. CurrentSince Oct 27, 2016 Accepting new patients

Locations

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

700 S Park St
Ste A
Madison, WI 53715
Phone (608) 260-2900

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

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.

Hospital & facility affiliations 9

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": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1255886453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST STE A",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST STE A",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERICK",
        "first_name": "MELISSA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3847-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255886453",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpierick260660@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mpierick260660@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LAJEUNESSE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.