Jacob William Diestelmann, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3608 Issued in WI

Practice address

1000 N Oak Ave
Marshfield, WI 54449-5703

Phone

(715) 387-5703

NPI assigned

Jul 6, 2017

Last updated

Feb 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037

Merit-based Incentive Payment System (MIPS)

Final score

80.58 of 100Reported as group

Quality

55.5

Promoting interoperability

100

Improvement activities

40

Cost

71.46

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
• Direct secure messaging: jacob.diestelmann@marshfieldclinichealthsystem.cernerdirect.com

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.

• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment Care Compare group NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Eau Claire Cancer Center

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD

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

• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Rural Acute Care Hospital
  • Marshfield, WI
  • NPI 1942749387
  Care Compare affiliation

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1376064709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIESTELMANN",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-06",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anthony H Devries, M.D.
• Edna O Devries, MD
• Troy Donald Deyoung, CRNA
• Margo Elaine Diamond-Robertson
• Julene Diedrich, NP
• Christine Marie Dietrich, APRN, GNP-BC
• Julie C Dietz, MD
• Ade R Dillon, MD
• Wesley William Dittman
• Matthew J Dombrowski, PA-C

• Psychologist in Marshfield, WI
• Providers in Marshfield, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.