Individual provider Active NPI

Jessica Ann Ursprung, PA-C

  • Physician Assistant
  • Green Bay, WI
National Provider Identifier
1376853671
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2666-23 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(920) 288-4060
Fax
(920) 288-4067
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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 2666-23 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320
Phone (920) 490-9046

Other identifiers 2

IdentifierTypeStateIssuer
1376853671MedicaidWI
363A00000XMedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jursprung63050@direct.aurora.org

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
I20110216001045 WI Practitioner - Physician Assistant 7911188453 Reassigns benefits to 4 organizations

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
Aurora Health Care North IncGroup PAC ID 9436067402, 19 clinicians

Practice addresses (Care Compare)

5000 Memorial Dr
Two Rivers, WI 54241-3900
Phone (920) 794-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Health Care Central, Inc. CurrentSince Nov 30, 2012 Accepting new patients
Aurora Health Care Central, Inc. CurrentSince Nov 30, 2012 Accepting new patients

Locations

901 Reed St
Plymouth, WI 53073
Phone (920) 451-5579

Organizations & group practices 5

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 1

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": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1376853671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-4060",
            "fax_number": "920-288-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URSPRUNG",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2666-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376853671",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363A00000X",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jursprung63050@direct.aurora.org",
            "affiliation": "N",
            "address_1": "2629 N 7th St",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530834932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.