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MRS. JILL MARIE HIETPAS PA C
NPI 1396796660
Physician Assistant in Appleton, WI

Active since May 12, 2006Opted out of Medicare · through Nov 29, 2026
1835 E EDGEWOOD DR STE 10535, APPLETON, WI 54913(920) 215-0102(920) 214-0795 Get Directions Write a Review

NPPES record last updated: October 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Jill Marie Hietpas Pa C NPPES

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

MRS. JILL MARIE HIETPAS PA C (NPI 1396796660) is an individual physician assistant in Appleton, Wisconsin, licensed in Wisconsin (1285023) and active in the NPI registry since May 2006. She has opted out of Medicare through November 29, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1396796660
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. JILL MARIE HIETPASCredential: PA C
Location Address1835 E EDGEWOOD DR STE 10535Appleton, WI 54913-9407
Mailing AddressN2611 Huss CtFreedom, WI 54130-8674 · (920) 915-2669
Phone(920) 215-0102
Fax(920) 214-0795
Sole ProprietorNo
Enumeration DateMay 12, 2006
Last NPPES UpdateOctober 26, 2023
NPPES CertifiedOctober 26, 2023
✔ NPI 1396796660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WI · 1285023
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.
1835 E EDGEWOOD DR STE 10535, Appleton, WI 54913
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Other Identifiers 1

Medicaid32494700WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Jill Marie Hietpas Pa C has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 29, 2022 through November 29, 2026.

Opt-Out Effective DateNovember 29, 2022
Opt-Out In Effect ThroughNovember 29, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54913 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.

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 Jill Hietpas's NPI number?

The NPI number for Jill Hietpas is 1396796660. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Where is Jill Hietpas located?

Jill Hietpas practices at 1835 E Edgewood Dr Ste 10535, Appleton, WI 54913. The listed phone number is (920) 215-0102.

What is Jill Hietpas's specialty?

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

Is Jill Hietpas enrolled in Medicare?

No. Jill Hietpas has opted out of Medicare through November 29, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jill Hietpas was last updated on October 26, 2023. 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.