JENNA J MULDER – Physician Assistant, NPI 1053929653
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for JENNA J MULDER
100 COUNTY ROAD B
SHAWANO, WI 541667072
Phone: (715) 526-2111
Fax: (715) 526-9366
Type: Location
3 NEENAH CTR FL 5
NEENAH, WI 549563070
Phone: (920) 830-5900
Fax: (920) 830-5910
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 29 Open Payments records for all available years, with a total value of $703.
Total Amount is formed as General ($703) + Research ($0) + Ownership ($0) = $703.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Janssen Biotech, Inc. ($139).
Total Amount
$703
General + Research + Ownership
Payments
29
Total payment records
General Amount
$703
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-10-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201001000362 | I | Physician Assistant | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 54166)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | WV | |
| Physician Assistant | WI | |
| Nurse Practitioner | WI | |
| General Surgery, Colorectal Surgery (Proctology), Surgical Oncology, Thoracic Surgery, Vascular Surgery | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | WI | |
| General Surgery | WI | |
| General Surgery | WI | |
| Nurse Practitioner | WI |
Reviews
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