Individual provider Active NPI

Kaylee Jensen

  • Physician Assistant
  • Wausau, WI
National Provider Identifier
1629701941
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7967-23 Issued in WI
Practice address
902 N 3Rd St
Wausau, WI 54403-4708
Phone
(715) 841-9830
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 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 7967-23 WI Primary

Addresses

Primary practice location

902 N 3Rd St
Wausau, WI 54403-4708

Mailing address

708 Washington St
Wausau, WI 54403-5667

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
I20240828004957 WI Practitioner - Physician Assistant 4486193810 Reassigns benefits to 3 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
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians
Aspirus Medical Group, Inc.Group PAC ID 1052223625, 272 clinicians

Practice addresses (Care Compare)

333 Pine Ridge Blvd
Wausau, WI 54401-4102

4005 Community Ctr Dr
Weston, WI 54476-4139
Phone (715) 241-5400

500 Wind Ridge Dr
Wausau, WI 54401-4173
Phone (715) 847-2611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7967-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Sep 1, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

902 N 3rd St
Wausau, WI 54403
Phone (715) 841-9830

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

2031 Peach St
Wisconsin Rapids, WI 54494
Phone (715) 423-0122

Interoperability endpoints

  • Direct secure messaging: kjensen201617@direct.aspirus.org

Organizations & group practices 7

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 10

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": "1718582400000",
    "number": "1629701941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 WASHINGTON ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N 3RD ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544034708",
            "telephone_number": "715-841-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KAYLEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "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": "7967-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.