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Jay Michael Ferguson

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as JAY FERGUSON.

Based on the most recent information from CMS, provider Jay Michael Ferguson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1174690853
Provider Type
Individual
Full Name
Ferguson, Jay Michael
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
11/29/2006
Last Updated
7/23/2021

Contact Information

Practice Location

3500 Tower Ave, Superior, WI 54880-5335

(715) 395-5454

Unlisted Fax

Mailing Location

3500 Tower Ave, Superior, WI 54880-5335

(715) 395-5454

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 9175 Minnesota
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 1802 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 41997800	Description Medicaid	Issuer Unlisted Wisconsin

Jay Michael Ferguson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Senger, Christopher Dean

Lesneski, Gregory Michael

Grimm, Rhiannon Elise

Potter, James G

Johnson, Sarah Elizabeth

Anderson, Leslie Ann

Rajaguru, Labutale Walawwe

Karl, Sarah Lynn

Kunze, Zoe

Fisker, Erin Lee