KELLY THERESIA DASSOW FNP
NPI 1184359499
Nurse Practitioner - Family in Stevens Point, WI
About Kelly Theresia Dassow Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY THERESIA DASSOW FNP (NPI 1184359499) is an individual family provider in Stevens Point, Wisconsin, licensed in Wisconsin (13193) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Marshfield, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly Theresia Dassow Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelly Dassow reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Marshfield, WI 54449
- Reassigned Medicare billing, Wisconsin enrollment
- 11 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54482 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Dassow's NPI number?
The NPI number for Kelly Dassow is 1184359499. It was assigned to this individual provider in the NPPES registry on July 20, 2022.
Where is Kelly Dassow located?
Kelly Dassow practices at 4100 State Highway 66, Stevens Point, WI 54482. The listed phone number is (715) 997-6000.
What is Kelly Dassow's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kelly Dassow enrolled in Medicare?
Yes. Kelly Dassow is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelly Dassow's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Dassow reassigns Medicare benefits to Wellbe Wisconsin Sc (Marshfield, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Dassow's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelly Dassow was last updated on February 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelly Theresia Dassow, FNP · NPI 1184359499
Family physician in Stevens Point, Wisconsin. Individual provider, active in the CMS NPPES registry since July 20, 2022.
## Identity
- **NPI:** 1184359499 (Entity type: Individual)
- **Enumerated:** July 20, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 13193 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 4100 STATE HIGHWAY 66, Stevens Point, WI 54482-8410
- **Phone:** (715) 997-6000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Wellbe Wisconsin Sc (NPI 1801622881, Marshfield, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** February 28, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1184359499) · Data from the CMS NPPES public registry.