Active NPI
Jessica M Stimson, PA-C
- Medical Physician Assistant
- Madison, WI
National Provider Identifier
1619146453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2128-023
- Practice address
- 1313 Fish Hatchery Rd
Dean Medical Center
Madison, WI 53715-1911 - Phone
- (608) 252-8000
- Fax
- (608) 252-8248
- NPI assigned
- Feb 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2128-023 | WI | Primary |
| Surgical Physician Assistant | 363AS0400X | 2128-023 | WI |
Addresses
Primary practice location
1313 Fish Hatchery Rd
Dean Medical Center
Madison, WI 53715-1911
Mailing address
1313 Fish Hatchery Rd
Dean Medical Center
Madison, WI 53715-1911
Phone (608) 252-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41953800 | Medicaid | WI | |
| 60784 | Other | WI | DEAN HEALTH INSURANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2128 | WI | MD | Registered Dietitian |
| 2128-023 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Allergy & Immunology Physician
- Madison, WI
- NPI 1053358846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1619146453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1313 FISH HATCHERY RD",
"address_2": "DEAN MEDICAL CENTER",
"city": "MADISON",
"state": "WI",
"postal_code": "537151911",
"telephone_number": "608-252-8000",
"fax_number": "608-252-8248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 FISH HATCHERY RD",
"address_2": "DEAN MEDICAL CENTER",
"city": "MADISON",
"state": "WI",
"postal_code": "537151911",
"telephone_number": "608-252-8000",
"fax_number": "608-252-8248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIMSON",
"first_name": "JESSICA",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-26",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WI",
"license": "2128-023",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WI",
"license": "2128-023",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41953800",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH INSURANCE",
"identifier": "60784",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.