Individual provider Active NPI

Hannah Elise Zenkovich

  • Physician Assistant
  • Birnamwood, WI
National Provider Identifier
1023741022
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
180759 Sportsman Dr
Birnamwood, WI 54414-5249
Phone
(715) 219-4161
NPI assigned
Jul 6, 2022
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

180759 Sportsman Dr
Birnamwood, WI 54414-5249

Mailing address

180759 Sportsman Dr
Birnamwood, WI 54414-5249
Phone (715) 219-4161

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
I20240904002656 WI Practitioner - Physician Assistant 5395285431 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Upland Hills Health, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Upland Hills Health, Inc CurrentSince Jan 18, 2025 Accepting new patients
Prairie Ridge Health Inc. CurrentSince Nov 1, 2025 Accepting new patients
Prairie Ridge Health, Inc. Current Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Upland Hills Health, Inc, CurrentSince Jan 18, 2025 Accepting new patients

Locations

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

1809 Springdale St
Mount Horeb, WI 53572
Phone (608) 437-8033

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1023741022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180759 SPORTSMAN DR",
            "city": "BIRNAMWOOD",
            "state": "WI",
            "postal_code": "544145249",
            "telephone_number": "715-219-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180759 SPORTSMAN DR",
            "city": "BIRNAMWOOD",
            "state": "WI",
            "postal_code": "544145249",
            "telephone_number": "715-219-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENKOVICH",
        "first_name": "HANNAH",
        "middle_name": "ELISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birnamwood, WI

Sources for this page

Verify at the official NPI Registry.