Jennifer L Roth, FNP-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

248734 Issued in AZ

Practice address

1700 Tuttle St
Baraboo, WI 53913-3319

Phone

(608) 355-3800

Fax

(608) 355-7001

NPI assigned

Jan 11, 2021

Last updated

Mar 2, 2022By the provider in NPPES

Sex

Female

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

Other names 1

• Jennifer Lee Matyskela Former name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Wisconsin Emergency Associates SCGroup PAC ID 3274561055, 47 clinicians

Stoughton Hospital AssociationGroup PAC ID 7012825706, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stoughton Hospital Hospital, Stoughton, WI, CCN 521343

Merit-based Incentive Payment System (MIPS)

Final score

85.73 of 100Reported as group

Quality

87.42

Promoting interoperability

100

Improvement activities

40

Cost

65.02

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jroth262909@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Wisconsin Emergency Associates SC

  • Emergency Medicine Physician
  • Beloit, WI
  • NPI 1568538189
  Medicare reassignment Care Compare group NPD
• Stoughton Hospital Association

  • Critical Access Hospital
  • Stoughton, WI
  • NPI 1679558647
  Medicare reassignment Care Compare group NPD
• Edgerton Hospital and Health Services Inc.

  • Critical Access Hospital
  • Edgerton, WI
  • NPI 1154350049
  Medicare reassignment NPD
• Swea Fort SC

  • Emergency Medicine Physician
  • Fort Atkinson, WI
  • NPI 1295552065
  Medicare reassignment NPD
• Edgerton Hospital and Health Services Inc

  • Podiatrist
  • Edgerton, WI
  • NPI 1083310908
  NPD
• Edgerton Hospital and Health Services, Inc

  • Urgent Care Clinic/Center
  • Whitewater, WI
  • NPI 1982496295
  NPD
• Stoughton Hospital Association

  dba Cottage Grove Urgent Care

  • Urgent Care Clinic/Center
  • Cottage Grove, WI
  • NPI 1811733066
  NPD
• Mikrut Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Prescott, AZ
  • NPI 1649223306
  NPD (past)

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

• Stoughton Hospital Association

  dba McFarland Urgent Care

  • Urgent Care Clinic/Center
  • McFarland, WI
  • NPI 1477146082

  Hospital

  Care Compare affiliation
• Stoughton Hospital Association

  • Critical Access Hospital
  • Stoughton, WI
  • NPI 1679558647
  Care Compare affiliation
• Stoughton Hospital Association

  dba Cottage Grove Urgent Care

  • Urgent Care Clinic/Center
  • Cottage Grove, WI
  • NPI 1811733066

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1902495468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TUTTLE ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539133319",
            "telephone_number": "608-355-3800",
            "fax_number": "608-355-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TUTTLE ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539133319",
            "telephone_number": "608-355-3800",
            "fax_number": "608-355-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11004-33",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "248734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902495468",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MATYSKELA",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Debra K Rodriguez, NP
• Rhonda D Roll
• Angela Romportl
• Donna T. Rose, PH.D.
• Heidi M. Roth
• Mary Ann Roth, LPC
• Jane Rufe
• April Ruhland, MS, CCC-SLP
• Valerie M Rung, MA, LPC-IT
• Kandi Kay Ryan, RN

• Family Medicine Physician in Baraboo, WI
• Providers in Baraboo, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.