JERALD DIETRICH CHARLES PA-C
NPI 1396284154
Physician Assistant in Green Bay, WI

Q: What is Jerald Charles's NPI number?

The NPI number for Jerald Charles is 1396284154. It was assigned to this individual provider in the NPPES registry on February 13, 2017.

Q: What is Jerald Charles's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jerald Charles was last updated on December 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since February 13, 2017PECOS EnrolledAccepts Medicare Assignment

2845 GREENBRIER RD, GREEN BAY, WI 54311(920) 288-8320 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 14, 2021, Jun 15, 2021, Jul 17, 2017 and 1 more (4 updates tracked since 2017).

On this page

About Jerald Dietrich Charles Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERALD DIETRICH CHARLES PA-C (NPI 1396284154) is an individual physician assistant in Green Bay, Wisconsin, licensed in Wisconsin (4028-023) and active in the NPI registry since February 2017. He is enrolled in Medicare PECOS, is affiliated with Aurora Baycare Medical Ctr, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1396284154

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJERALD DIETRICH CHARLESCredential: PA-C

Location Address2845 GREENBRIER RDGreen Bay, WI 54311-6519

Mailing Address164 N. BroadwayGreen Bay, WI 54303-2728 · (920) 490-9046

Phone(920) 288-8320

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateFebruary 13, 2017

Last NPPES UpdateDecember 14, 20214 updates tracked since enumeration

NPPES CertifiedDecember 14, 2021

✔ NPI 1396284154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 4028-023

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X

2845 GREENBRIER RD, Green Bay, WI 54311

Open in Google Maps ↗

Other Identifiers 1

Medicaid100068010WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jerald Dietrich Charles Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941579973

PECOS Enrollment IDI20170707001329

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

27 services12 patients

Coronary artery bypass using artery graft, 1 graft 33533

A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.

14 services14 patients

Harvest of vein using an endoscope 33508

Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.

13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Aurora Baycare Medical Ctr

Acute Care Hospitals · Green Bay, WI

5/5 CMS rating

OwnershipProprietary

CMS Certification Number520193

Location2845 Greenbrier RdGreen Bay, WI 54311 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54311 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

AMRITHA CHANDRAHASA KARKERA M.D.

Internal Medicine (Hematology & Oncology)