JESSICA E MUCCIANTI (PA C) – Physician Assistant, NPI 1104065598
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for JESSICA E MUCCIANTI (PA C)
PO BOX 78866
MILWAUKEE, WI 532788866
Phone: (779) 696-7150
Fax: (779) 696-7342
Type: Mailing
Swedish American Clinic, 1253, North Alpine Road, Rockford, Winnebago County, Illinois, 61107, United States
ROCKFORD, IL 61107
Phone: (779) 696-9201
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2024-01-29 • Largest payer in this snapshot: Boston Scientific Corporation ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $14 |
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: 2009-03-24
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 |
|---|---|---|---|---|
| I20090324000314 | I | Physician Assistant | IL | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 69210 | Removal of impacted ear wax | 256 | 152 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 31 | 31 | $0 |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 27 | 26 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 21 | 21 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 15 | 14 | $0 |
Insurance plans in this area (ZIP 53278)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| E N D O C R I N O L O G Y | IA | |
| Family Practice | WI | |
| Physical Therapist In Private Practice | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| Internal Medicine | WI | |
| N E U R O S U R G E R Y | IL | |
| - | WI | |
| Orthopedic Surgery | WI | |
| - | WI |
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