Individual provider Active NPI

Michael Christian

  • Physician Assistant
  • Menomonie, WI
National Provider Identifier
1073164299
Registry record updated Sep 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4902-23 Issued in WI
Practice address
E5834 689TH Ave
Menomonie, WI 54751-5008
Phone
(715) 360-6527
NPI assigned
Sep 28, 2019
Last updated
Sep 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2019

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 4902-23 WI Primary

Addresses

Primary practice location

E5834 689TH Ave
Menomonie, WI 54751-5008

Mailing address

E5834 689TH Ave
Menomonie, WI 54751-5008
Phone (715) 360-6527

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
I20210218001867 WI Practitioner - Physician Assistant 4284049560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.05 of 100Reported as group
Quality
87.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4902-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Services, Inc CurrentSince Jan 1, 2021 Accepting new patients
Medical Services, Inc CurrentSince Jan 1, 2021 Accepting new patients

Locations

11040 N State Road 77
Hayward, WI 54843
Phone (715) 934-4244

Organizations & group practices 2

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": "1569628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569628800000",
    "number": "1073164299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E5834 689TH AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547515008",
            "telephone_number": "715-360-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E5834 689TH AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547515008",
            "telephone_number": "715-360-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-28",
        "last_updated": "2019-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4902-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

Verify at the official NPI Registry.