Active NPI
Jacob Paul Meyer
- Family Medicine Physician
- Green Bay, WI
National Provider Identifier
1922528801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 7355920
- Practice address
- 1630 Commanche Ave
Green Bay, WI 54313-5753 - Phone
- (920) 430-4700
- NPI assigned
- Jun 22, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 7355920 | WI | Primary |
Addresses
Primary practice location
1630 Commanche Ave
Green Bay, WI 54313-5753
Mailing address
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4700
Other practice location 1
983075 Nebraska Medical Ctr
Omaha, NE 68198-3075
Phone (402) 559-7200
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Wisconsin School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4700
Hospital & facility affiliations
- Bellin Home Health Agency
- Unity Hospice
- Bellin Memorial Hospital
- Bellin Health Oconto Hospital
- Woodside Lutheran Home
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7355920 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Family Medicine | Current | Accepting new patients |
| Bellin Memorial Hospital Inc | Family Medicine | Current | Accepting new patients |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Family Medicine | Past | Accepting new patients |
Locations
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700
Interoperability endpoints
- jmeyer916421@direct.emplifyhealth.org
- jmeyer296268@direct.thedacare.org
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
-
- Cardiovascular Disease Physician
- Manitowoc, WI
- NPI 1710130216
-
- Family Medicine Physician
- Brillion, WI
- NPI 1962464784
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Green Bay, WI
- NPI 1831246404
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1891740585
-
- Critical Access Hospital
- Oconto, WI
- NPI 1356373302
-
- Community Based Hospice Care Agency
- De Pere, WI
- NPI 1194797910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602979200000",
"number": "1922528801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1630 COMMANCHE AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543135753",
"telephone_number": "920-430-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 COMMANCHE AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543135753",
"telephone_number": "920-430-4700"
}
],
"practiceLocations": [
{
"address_1": "983075 Nebraska Medical Ctr",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681983075",
"country_code": "US",
"telephone_number": "402-559-7200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEYER",
"first_name": "JACOB",
"middle_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-22",
"last_updated": "2020-10-18",
"certification_date": "2020-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "7355920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; 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.