Individual provider Active NPI

Steven P Kisch, PA

  • Surgical Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1003860347
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1172023 Issued in WI
Practice address
9200 W Wisconsin Ave
Department of Neurosurgery
Milwaukee, WI 53226-3522
Phone
(414) 805-5400
Fax
(414) 955-0115
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1172023 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Department of Neurosurgery
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Department of Neurosurgery
Milwaukee, WI 53226-3522
Phone (414) 805-5400

Other identifiers 2

IdentifierTypeStateIssuer
003006261QOtherHUMANA
1003860347MedicaidWI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090630000220 WI Practitioner - Physician Assistant 0749331965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

1155 N Mayfair Rd
FL 2
Milwaukee, WI 53226-3462
Phone (414) 955-4263

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051-2301
Phone (232) 532-1100

W180 N8065 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

W180N8071 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 253-2700

W180N8085 Town Hall Rd
Suite 301
Menomonee Falls, WI 53051-3518
Phone (262) 257-3200

Hospital & facility affiliations

  • Community Memorial Hospital Hospital, Menomonee Falls, WI, CCN 520103
  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1172023WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Aug 28, 2019 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Aug 28, 2019 Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

Interoperability endpoints

  • Direct secure messaging: skischpac6985@direct.froedtert.com

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1003860347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF NEUROSURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5400",
            "fax_number": "414-955-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF NEUROSURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5400",
            "fax_number": "414-955-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISCH",
        "first_name": "STEVEN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1172023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "003006261Q",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003860347",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.