Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob J. Demelle, PA-C

Individual provider Physician Assistant · NPI 1558522664

Jacob J. Demelle, PA-C is a Physician Assistant in Green Bay, Wisconsin. Qualified in 2008, 18 years ago. Practices with St Vincent Hospital-Hospital Sisters-Third Order of St Francis, a 594-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
18
Licensed in
WI
In the registry since
2008
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1821 S Webster Ave
Green Bay, WI 54301-2253
Phone: (920) 496-4700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2269 (WI)

Record details

NPI number1558522664
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 20, 2008
Last updated in NPPESOctober 11, 2022
Certification dateOctober 11, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice St Vincent Hospital-Hospital Sisters-Third Order Of St Francis — 594 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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