NPIMap

Individual provider Active NPI

Jessica Ann Weddle, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Wausau, WI
National Provider Identifier
1275725913
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
5101016320 Issued in MI
Practice address
512 S 28TH Ave
Wausau, WI 54401-4147
Phone
(715) 847-2020
Fax
(715) 847-2325
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 5101016320 MI Primary

Addresses

Primary practice location

512 S 28TH Ave
Wausau, WI 54401-4147

Mailing address

512 S 28TH Ave
Wausau, WI 54401-4147
Phone (715) 847-2020

Other names 1

  • Dr. Jessica Ann Weddle Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000453 WI Practitioner - Otolaryngology 8628102209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates SCGroup PAC ID 2062429608, 25 clinicians
Aspirus Rhinelander and Tomahawk Hospitals and Clinics, Inc.Group PAC ID 9335059856, shared by 17 NPIs, 566 clinicians

Practice addresses (Care Compare)

512 S 28TH Ave
Wausau, WI 54401-4147
Phone (715) 847-2021

824 Illinois Ave
Stevens Point, WI 54481-3112
Phone (715) 344-1600

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
  • Marshfield Medical Center - Weston Hospital, Weston, WI, CCN 520202
  • Aspirus Stevens Point Hospital & Clinics, Inc. Hospital, Stevens Point, WI, CCN 520002
  • Aspirus Tomahawk Hospital Hospital, Tomahawk, WI, CCN 521313

Merit-based Incentive Payment System (MIPS)

Final score
92.72 of 100Reported as group
Quality
99.98
Promoting interoperability
100
Improvement activities
40
Cost
75.74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016320MIMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT & Allergy Associates, S.C. CurrentSince Jul 1, 2010 Accepting new patients
Aspirus Medical Group, Inc. Past Accepting new patients

Locations

5509 Vern Holmes Dr
Stevens Point, WI 54482
Phone (715) 847-2021

2801 Westhill Dr
Wausau, WI 54401
Phone (715) 847-2021

512 S 28th Ave
Wausau, WI 54401
Phone (715) 847-2021

Interoperability endpoints

  • Direct secure messaging: jweddle22498@direct.aspirus.org

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1275725913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 S 28TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014147",
            "telephone_number": "715-847-2020",
            "fax_number": "715-847-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 S 28TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014147",
            "telephone_number": "715-847-2020",
            "fax_number": "715-847-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDDLE",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101016320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WEDDLE",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.