Jesse R Primeau, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003683 Issued in MI

Practice address

500 Campus Dr
Hancock, MI 49930-1569

Phone

(906) 483-1777

NPI assigned

Jun 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portage Physician Practices IncGroup PAC ID 6103053509, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Up Health System Portage Hospital, Hancock, MI, CCN 230108

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jesse.primeau.1@8233.direct.athenahealth.com

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.

• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684
  Medicare reassignment Care Compare group NPD (past)
• Portage Physician Practices Inc

  • Rural Health Clinic/Center
  • Calumet, MI
  • NPI 1164106910
  NPD
• Portage Hospital LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Hancock, MI
  • NPI 1821425612
  NPD (past)
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD (past)

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

• Portage Hospital LLC

  • General Acute Care Hospital
  • Hancock, MI
  • NPI 1245667229
  Care Compare affiliation

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1689612012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301569",
            "telephone_number": "906-483-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301569",
            "telephone_number": "906-483-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMEAU",
        "first_name": "JESSE",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1486-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41960500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Portage Hospital LLC
• Portage Hospital LLC
• Portage Physician Practices Inc
• Portage Physician Practices Inc
• Verdon Jill Posey
• Amy Sue Anne Rajala
• Madison Adeline Rajala
• Lenora D Rautio, CHW
• Nancy L Reed, MA, CCCA
• Robert Donold Richards, DDS

• Physician Assistant in Hancock, MI
• Providers in Hancock, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.