NPIMap

Individual provider Active NPI

Kastyn Alice Hebbe

  • Physician Assistant
  • Jefferson, WI
National Provider Identifier
1356074561
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8006-23 Issued in WI
Practice address
W3064 Hagedorn Rd
Jefferson, WI 53549-9745
Phone
(920) 723-8447
NPI assigned
Jul 5, 2022
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 8006-23 WI Primary

Addresses

Primary practice location

W3064 Hagedorn Rd
Jefferson, WI 53549-9745

Mailing address

W3064 Hagedorn Rd
Jefferson, WI 53549-9745
Phone (920) 723-8447

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
I20240923001126 WI Practitioner - Physician Assistant 0244771871 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upland Hills Health IncGroup PAC ID 3072415553, shared by 13 NPIs, 97 clinicians

Practice addresses (Care Compare)

1883 Springdale St
Mount Horeb, WI 53572-2477
Phone (608) 437-8040

551 Main St
Highland, WI 53543-9779
Phone (608) 929-4518

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upland Hills Health, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Upland Hills Health, Inc CurrentSince Jan 1, 2025 Accepting new patients
Upland Hills Health, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Prairie Ridge Health Inc. CurrentSince Nov 1, 2025 Accepting new patients

Locations

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

Interoperability endpoints

  • Direct secure messaging: khebbe453522@direct-ehr-ssmhc.com

Organizations & group practices 9

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 4

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1356074561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3064 HAGEDORN RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499745",
            "telephone_number": "920-723-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3064 HAGEDORN RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499745",
            "telephone_number": "920-723-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBBE",
        "first_name": "KASTYN",
        "middle_name": "ALICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8006-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

Verify at the official NPI Registry.