Individual provider Active NPI

Nathan John Stocco, PA

  • Physician Assistant
  • Lancaster, WI
National Provider Identifier
1649794991
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4630-23 Issued in WI
Practice address
507 S Monroe St
Lancaster, WI 53813-2054
Phone
(608) 723-2131
Fax
(608) 723-2707
NPI assigned
Jul 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 088418 IA
Physician Assistant 363A00000X 4630-23 WI Primary

Addresses

Primary practice location

507 S Monroe St
Lancaster, WI 53813-2054

Mailing address

507 S Monroe St
Lancaster, WI 53813-2054
Phone (608) 723-2131

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
I20190401000363 WI Practitioner - Physician Assistant 5890060933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grant Regional Health Center IncGroup PAC ID 9638079445, 36 clinicians

Practice addresses (Care Compare)

507 S Monroe St
Lancaster, WI 53813-2054
Phone (608) 723-2131

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Regional Health Center, Inc. Physician Assistant CurrentSince Mar 1, 2019 Accepting new patients
Grant Regional Health Center, Inc CurrentSince Mar 1, 2019 Accepting new patients

Locations

222 W Amelia St
Cassville, WI 53806
Phone (608) 723-2131

1525 Lafollette St
Fennimore, WI 53809
Phone (608) 723-2131

507 S Monroe St
Lancaster, WI 53813
Phone (608) 723-2131

114 US Highway 61 N
Potosi, WI 53820
Phone (608) 723-2131

Organizations & group practices 2

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": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1649794991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S MONROE ST",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132054",
            "telephone_number": "608-723-2131",
            "fax_number": "608-723-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S MONROE ST",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132054",
            "telephone_number": "608-723-2131",
            "fax_number": "608-723-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCCO",
        "first_name": "NATHAN",
        "middle_name": "JOHN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-28",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "088418",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4630-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, WI

Sources for this page

Verify at the official NPI Registry.