Andrea Agnes Miklosi, PA-C
Individual provider Active NPI Surgical Physician Assistant · Franklin, WI
NPI 1104489616 · NPPES record last updated Jan 31, 2025
Key facts
- NPI
- 1104489616
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 4873 (WI)
- Practice address
- 10500 W Loomis Rd Ste 130
Franklin, WI 53132-8030 - Phone
- (414) 488-1111
- NPI assigned
- Apr 19, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|---|
| I20191231001064 | WI | Practitioner - Physician Assistant | 6608200571 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4873 | WI | MD | Surgical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant |
363AS0400X | 4873 | WI | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X |
Addresses
Primary practice location
10500 W Loomis Rd Ste 130
Franklin, WI 53132-8030
Mailing address
10500 W Loomis Rd Ste 130
Franklin, WI 53132-8030
Phone (906) 221-5533
Other providers in Franklin, WI
- Crystal Michalak
- Michelle L. Lamers, D.D.S, L.L.C.
- Midwest Orthopedic Specialty Hospital, LLC
- Midwest Orthopedic Specialty Hospital, LLC
- Midwest Orthopedic Specialty Hospital, LLC
- Douglas Milosavljevic
- Milwaukee Clinic of Ortho Surgery, LTD.
- Milwaukee Eye Care Associates S.C.
- Milwaukee Sports Therapy
- Milwaukee Surgical Specialists SC
All providers in Franklin, WI · Surgical 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 Jan 31, 2025. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.