Individual provider Active NPI

Elizabeth M Jermier, PAC

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1285948935
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3255-23 Issued in WI
Practice address
700 South Park Street
Madison, WI 53713
Phone
(608) 251-6100
Fax
(608) 258-5222
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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 3255-23 WI Primary

Addresses

Primary practice location

700 South Park Street
Madison, WI 53713

Mailing address

700 South Park Street
Madison, WI 53713
Phone (608) 251-6100

Other identifiers 1

IdentifierTypeStateIssuer
1285948935MedicaidWI

Other names 1

  • Miss Elizabeth Marie Jahnke Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ejermier262949@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20140226000498 WI Practitioner - Physician Assistant 1658567862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
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 N Water St
Evansville, WI 53536-1152
Phone (608) 882-5170

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

103 Lake St
Deerfield, WI 53531-9455
Phone (608) 764-5487

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

130 Corporate Dr
Beaver Dam, WI 53916-3116
Phone (920) 877-3102

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

1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200

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

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

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

753 N Main St
Oregon, WI 53575-1003
Phone (608) 835-2222

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3255-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Nov 2, 2016 Accepting new patients
Dean Health Systems, Inc CurrentSince Nov 2, 2016 Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients
Center for Psychiatric Care PastSince Aug 28, 2000 Accepting new patients

Locations

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

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

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

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1285948935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SOUTH PARK STREET",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53713",
            "telephone_number": "608-251-6100",
            "fax_number": "608-258-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SOUTH PARK STREET",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53713",
            "telephone_number": "608-251-6100",
            "fax_number": "608-258-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERMIER",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3255-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285948935",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ejermier262949@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ejermier262949@direct-ehr-ssmhc.com",
            "address_1": "700 South Park Street",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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 South Park Street",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "JAHNKE",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.