Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jared William Kiernicki, PA-C

Individual provider Physician Assistant · NPI 1376883397

Mr. Jared William Kiernicki, PA-C is a Physician Assistant in Green Bay, Wisconsin. Qualified in 2017, 9 years ago. Practices with Bellin Memorial Hospital Inc, a 681-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Indiana, Kentucky and Wisconsin.

Years since qualifying
9
Licensed in
IN, KY, WI
In the registry since
2013
Specialties on file
3
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

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone: (920) 430-4888
Fax: (920) 430-4889
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 5828 Pearl Dr, Evansville, IN 47712-8116 — (812) 424-9291
  • 4011 Gateway Blvd Ste 100, Newburgh, IN 47630-8947 — (812) 424-9291
  • 10455 Orthopaedic Dr, Newburgh, IN 47630-7955 — (812) 424-9291

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5235-23 (WI)
Physician Assistant Taxonomy 363A00000X · Licence PA2286 (KY)
Physician Assistant Taxonomy 363A00000X · Licence 10002329A (IN)

Record details

NPI number1376883397
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 28, 2013
Last updated in NPPESJune 2, 2021
Certification dateJune 2, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Bellin Memorial Hospital Inc — 681 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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