Jacob J. Demelle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2269 Issued in WI

Practice address

1821 S Webster Ave
Green Bay, WI 54301-2253

Phone

(920) 496-4700

NPI assigned

Jun 20, 2008

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Hospital-Hospital Sisters-Third Order of St FrancisGroup PAC ID 5799694675, 593 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS Home Care Wisconsin Home health agency, Green Bay, WI, CCN 527132
• St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
• St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097

Merit-based Incentive Payment System (MIPS)

Final score

94.81 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdemelle28798@ewd.direct.hshs.org

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.

• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  • General Practice Physician
  • Green Bay, WI
  • NPI 1285613638
  Medicare reassignment Care Compare group
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340
  Medicare reassignment NPD
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1275799413
  Medicare reassignment NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Amherst, WI
  • NPI 1316616428
  NPD
• St Nicholas Hospital-Sisters of the Third Order of St Francis

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1447737762
  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  • Otolaryngology Physician
  • Shawano, WI
  • NPI 1194314013
  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  • Durable Medical Equipment & Medical Supplies
  • Green Bay, WI
  • NPI 1245042530
  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  • Gynecologic Oncology Physician
  • Green Bay, WI
  • NPI 1316991169
  NPD (past)

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

• St Mary'S Hospital Medical Center of Green Bay Inc.-Hospital Sisters

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1649246877
  Care Compare affiliation
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1114908001
  Care Compare affiliation
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  • Home Health Agency
  • Green Bay, WI
  • NPI 1679556526
  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St Francis

  • Hematology & Oncology Physician
  • Sheboygan, WI
  • NPI 1831784636

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  • Hematology & Oncology Physician
  • Green Bay, WI
  • NPI 1184004236

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  • Hematology & Oncology Physician
  • Oconto Falls, WI
  • NPI 1750760740

  Hospital

  Care Compare affiliation
• St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis

  • Hematology & Oncology Physician
  • Sturgeon Bay, WI
  • NPI 1760861751

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1558522664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012253",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMELLE",
        "first_name": "JACOB",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdemelle28798@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1821 S Webster Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543012253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joni Constance Delwiche, LCSW
• Kelly Jane Delzer, APNP, FNP-C
• Mackenzie Erin Delzer, MD
• Amy Demaio
• Nicole Lee Dembroski, CSFA
• Lauren R Demerath, PA-C
• Amy L Demerritt, H.I.S.
• Jessica June Demeuse, MA, BCBA
• Robert Knox Demott, MD
• James E Dempsey, MD

• Physician Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.