Individual provider Active NPI

Camrin Jade Dressel, PA-C

  • Physician Assistant
  • Mequon, WI
National Provider Identifier
1134813751
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7403-23 Issued in WI
Practice address
13133 N Port Washington Rd Ste G-18
Mequon, WI 53097-2420
Phone
(262) 243-5000
NPI assigned
Jun 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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 7403-23 WI Primary

Addresses

Primary practice location

13133 N Port Washington Rd Ste G-18
Mequon, WI 53097-2420

Mailing address

323 Hartwood LN
Hartland, WI 53029-2407

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
I20230711003856 WI Practitioner - Physician Assistant 6305205170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1011 Spring City Dr
Suite 250
Waukesha, WI 53186-5934
Phone (262) 928-0370

1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

13900 W National Ave
New Berlin, WI 53151-9515
Phone (262) 928-4500

2130 Big Bend Rd
Waukesha, WI 53189-7624
Phone (262) 928-7555

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900

2750 Golf Rd
Delafield, WI 53018-2062
Phone (262) 928-4900

790 Cornerstone Xing
Waterford, WI 53185-4582
Phone (262) 363-1977

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7403-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Jan 1, 2024 Accepting new patients
Prohealth Medical Group Inc CurrentSince Jan 1, 2024 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc PastSince Jun 11, 2023 Accepting new patients

Locations

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

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 1

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1134813751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 HARTWOOD LN",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530292407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13133 N PORT WASHINGTON RD STE G-18",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972420",
            "telephone_number": "262-243-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRESSEL",
        "first_name": "CAMRIN",
        "middle_name": "JADE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7403-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.