Individual provider Active NPI

Jessica Seidel, APNP, FNP-BC

  • Family Nurse Practitioner
  • Madison, WI
National Provider Identifier
1689271801
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10261 Issued in WI
Practice address
521 E Washington Ave
Madison, WI 53703-2900
Phone
(608) 729-9388
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 189834-30 WI
Family Nurse Practitioner 363LF0000X 10261 WI Primary

Addresses

Primary practice location

521 E Washington Ave
Madison, WI 53703-2900

Mailing address

733 Struck St Unit 45213
Madison, WI 53744-3644

Other practice location 1

1015 Gammon Lane
Madison, WI 53719
Phone (262) 716-1951

Other names 1

  • Jessica Tess Former name

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
I20210726001179 WI Practitioner - Nurse Practitioner 9234532482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hanna Medical Clinic SCGroup PAC ID 6901182955, 3 clinicians

Practice addresses (Care Compare)

3207 Laura LN
Suite 105
Middleton, WI 53562-1428
Phone (608) 203-8022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
189834-30WIMDAddiction (Substance Use Disorder) Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hanna Medical Clinic SC Family Medicine CurrentSince Aug 9, 2023 Accepting new patients
Monarch Health CurrentSince Jun 15, 2021 Accepting new patients

Locations

521 E Washington Ave
Madison, WI 53703
Phone (608) 669-5422

3207 Laura Ln
#105
Middleton, WI 53562
Phone (608) 203-8022

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23045/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1689271801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 STRUCK ST UNIT 45213",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537443644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032900",
            "telephone_number": "608-729-9388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Gammon Lane",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "53719",
            "country_code": "US",
            "telephone_number": "262-716-1951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEIDEL",
        "first_name": "JESSICA",
        "credential": "APNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "189834-30",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "TESS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.