Alyssa Zielke, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3336-23 Issued in WI

Practice address

240 Maple Ave
Prohealth Care Medical Associates Inc
Mukwonago, WI 53149-8475

Phone

(262) 928-1900

NPI assigned

Jun 9, 2014

Last updated

Apr 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Alyssa Gross Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440
  Medicare reassignment NPD
• Watertown Physician Practices LLC

  • Family Medicine Physician
  • Watertown, WI
  • NPI 1770964363
  Medicare reassignment
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Hartland, WI
  • NPI 1386785178
  NPD
• Watertown Physician Practices LLC

  dba Watertown Medical Clinic

  • Family Medicine Physician
  • Watertown, WI
  • NPI 1003383027

  Physician Assistant

  NPD
• Watertown Physician Practices LLC

  • Obstetrics & Gynecology Physician
  • Watertown, WI
  • NPI 1225412265

  Physician Assistant

  NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1003229964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MAPLE AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498475",
            "telephone_number": "262-928-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MAPLE AVE",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498475",
            "telephone_number": "262-928-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIELKE",
        "first_name": "ALYSSA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3336-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "GROSS",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haley Lynn Yager, STUDENT
• Joshua John Yanzer
• Joan E Zachow, PT
• Terry A Zarling, M.D.
• Cheryl Ann Zastrow, BSN

• Physician Assistant in Mukwonago, WI
• Providers in Mukwonago, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.