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ANDREA NICOLE JONES MD
NPI 1942643457
Pediatrics in Madison, WI

Active since April 15, 2013PECOS Enrolled
600 HIGHLAND AVE, MADISON, WI 53792(608) 265-5545 Get Directions Write a Review

NPPES record last updated: February 1, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 1, 2021, Nov 22, 2017, Aug 11, 2016 (3 updates tracked since 2016).

About Andrea Nicole Jones Md NPPES

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

ANDREA NICOLE JONES MD (NPI 1942643457) is an individual pediatrics provider in Madison, Wisconsin, licensed in Wisconsin (63232) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942643457
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameANDREA NICOLE JONESCredential: MD
Location Address600 HIGHLAND AVEMadison, WI 53792-0001
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531 · (608) 829-5485 · Fax (608) 833-0999
Phone(608) 265-5545
Sole ProprietorNo
Enumeration DateApril 15, 2013
Last NPPES UpdateFebruary 1, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 1, 2021
✔ NPI 1942643457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in WI · 63232
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedHospitalistTaxonomy 208M00000X · License 63232 (WI)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
600 HIGHLAND AVE, Madison, WI 53792
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrea Nicole Jones Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Andrea Jones reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Access Community Health Centers, Inc.
2.4 mi
Federally Qualified Health Center (FQHC)
1102 S PARK ST
Madison, WI 53715
  • Reassigned Medicare billing, Wisconsin enrollment
  • 124 clinicians in this Medicare group
NPI 1669654307 (608) 443-5500
University Of Wisconsin Medical Foundation, Inc
4.8 mi
Multi-Specialty
7974 UW HEALTH COURT
Middleton, WI 53562
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,832 clinicians in this Medicare group
NPI 1598784555 (608) 829-5485

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53792 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
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
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.

JASON ALAN CHRISTENSEN PHARMD
Pharmacist
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 2433
MADISON, WI 53792
Dane County (608) 662-0817
LAURA JEAN KOPPLIN MD, PHD
Ophthalmology
600 HIGHLAND AVE
MADISON, WI 53792
Dane County (608) 263-6070
HAGGI MAZEH MD
Surgery
600 HIGHLAND AVE
MADISON, WI 53792
Dane County (608) 265-8072
DR. SWAPNIL SUNIL LANJEWAR M.D.
Internal Medicine (Infectious Disease)
600 HIGHLAND AVE
MADISON, WI 53792
Dane County (608) 263-0946
DR. MATTHEW JAMES HOYT M.D.
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Dane County (608) 263-8100
VANESSA MERCEDES WELTEN MD MPH
Transplant Surgery
600 HIGHLAND AVE
MADISON, WI 53792
Dane County (617) 732-5500
JOHN HENRY NORMAN HARRISON
Anesthesiology
600 HIGHLAND AVE
MADISON, WI 53792
Dane County (608) 263-8100
PIPPA FROUKTE COSPER MD
Radiology (Radiation Oncology)
600 HIGHLAND AVE
MADISON, WI 53792
Dane County (608) 263-8500

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 Andrea Jones's NPI number?

The NPI number for Andrea Jones is 1942643457. It was assigned to this individual provider in the NPPES registry on April 15, 2013.

Where is Andrea Jones located?

Andrea Jones practices at 600 Highland Ave, Madison, WI 53792. The listed phone number is (608) 265-5545.

What is Andrea Jones's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Andrea Jones enrolled in Medicare?

Yes. Andrea Jones is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Andrea Jones's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Jones reassigns Medicare benefits to 2 organizations: Access Community Health Centers, Inc. (Madison, WI) and University Of Wisconsin Medical Foundation, Inc (Middleton, WI). Each 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 Andrea Jones's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andrea Jones accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield, Aspirus Health Plan and Group Health Cooperative-SCW and 3 other insurers list Andrea Jones as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Andrea Jones was last updated on February 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.