Individual provider Active NPI

Jared Vesperman, PT

  • Physical Therapist
  • Mauston, WI
National Provider Identifier
1801349378
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13487-24 Issued in WI
Practice address
1050 Division St
Mauston, WI 53948-1931
Phone
(608) 847-1422
NPI assigned
Aug 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13487-24 WI Primary

Addresses

Primary practice location

1050 Division St
Mauston, WI 53948-1931

Mailing address

205 Maritime Dr
Manitowoc, WI 54220-6826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190723002563 WI Practitioner - Physical Therapist in Private Practice 4284960691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3021 Voyager Dr
Green Bay, WI 54311-8303
Phone (920) 496-4700

3860 Monroe Rd
De Pere, WI 54115-8399
Phone (920) 496-4700

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13487-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2019 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Physical Therapist Current Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2019 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 1, 2019 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Physical Therapist CurrentSince Jul 1, 2019 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

3860 Monroe Rd
De Pere, WI 54115
Phone (920) 272-1200

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

205 Maritime Dr
Manitowoc, WI 54220
Phone (920) 482-1516

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 6

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": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1801349378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MARITIME DR",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542206826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931",
            "telephone_number": "608-847-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESPERMAN",
        "first_name": "JARED",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-01",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13487-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.