Krista Meredith Dahl-Koehler, PA-C
Individual provider Active NPI Physician Assistant · Milwaukee, WI
NPI 1104159136 · NPPES record last updated Apr 18, 2019
Key facts
- NPI
- 1104159136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 4334 (WI)
- Practice address
- 9200 W Wisconsin Ave
Milwaukee, WI 53226-3522 - Phone
- (414) 955-3222
- Fax
- (414) 955-0061
- NPI assigned
- Sep 9, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Reedsburg Area Medical Center Inc
Practice addresses (Care Compare)
2000 N Dewey Ave
Reedsburg, WI 53959-1049
Phone (608) 524-6487
Hospital & facility affiliations
- Reedsburg Area Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.62 of 100
- Quality
- 94.84
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190802000643 | WI | Practitioner - Physician Assistant | 6800933102 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1745 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Reedsburg Area Medical Center, Inc. | Current |
Accepting new patients | |
| Reedsburg Area Medical Center Inc | Current |
Accepting new patients |
Locations
2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487
1104 21st St
Reedsburg, WI 53959
Phone (608) 524-4303
Interoperability endpoints
- kdahlkoehler776169@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1745 | TN | |
| Physician Assistant | 363A00000X | 4334 | WI | Yes |
Addresses
Primary practice location
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Mailing address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 955-3222
Other providers in Milwaukee, WI
- Nora Dahbur
- Manal A Dahcha
- Aziza Daher
- Jamal-Eddin Daher
- Rani Daher
- Tiagan Dahl
- Ann M Dahlberg
- Kevin James Dahlman
- Maureen Dahlmann
- Elijah Dahlstrom
All providers in Milwaukee, WI · Physician Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.