JACOB J. DEMELLE PA-C
NPI 1558522664
Physician Assistant in Green Bay, WI

Q: What is Jacob Demelle's NPI number?

The NPI number for Jacob Demelle is 1558522664. It was assigned to this individual provider in the NPPES registry on June 20, 2008.

Q: What is Jacob Demelle'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 Jacob Demelle was last updated on October 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 June 20, 2008PECOS EnrolledAccepts Medicare Assignment

94.61/100

CMS Quality Rating

1821 S WEBSTER AVE, GREEN BAY, WI 54301(920) 496-4700 Get Directions Write a Review

NPPES record last updated: October 11, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jacob J. Demelle Pa-c NPPES

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

JACOB J. DEMELLE PA-C (NPI 1558522664) is an individual physician assistant in Green Bay, Wisconsin, licensed in Wisconsin (2269) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1558522664

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJACOB J. DEMELLECredential: PA-C

Location Address1821 S WEBSTER AVEGreen Bay, WI 54301-2253

Mailing AddressPo Box 19070Green Bay, WI 54307-9070 · (920) 496-4700

Phone(920) 496-4700

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJune 20, 2008

Last NPPES UpdateOctober 11, 2022

NPPES CertifiedOctober 11, 2022

✔ NPI 1558522664 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 · 2269

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.

1821 S WEBSTER AVE, Green Bay, WI 54301

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Security Health Plan.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

Jacob J. Demelle 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 ID4587738109

PECOS Enrollment IDI20080730000798

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 5

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

133 services19 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

41 services27 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

31 services22 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

13 services11 patients

Treatment of broken neck of thigh bone with bone implant 27245

This procedure involves repairing a fractured thigh bone by inserting a bone implant. The implant helps stabilize the bone, allowing it to heal correctly. It's performed under anesthesia and requires a hospital stay for recovery.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number520097

Location1726 Shawano AveGreen Bay, WI 54303 · Brown County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54301 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.

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.

94.61/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

85.17

Promoting Interoperability

100

Improvement Activities

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.

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