Don D. Axt, P.A.

Individual provider Active NPI Physician Assistant · Menomonee Falls, WI

NPI 1154366367 · NPPES record last updated Aug 26, 2010

Key facts

NPI
1154366367
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
396 (WI)
Practice address
W180N8085 Town Hall Rd
3SW Suite 4
Menomonee Falls, WI 53051-3518
Phone
(262) 532-6899
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. Past Accepting new patients
Aurora Advanced Healthcare Inc Past Accepting new patients
Advanced Healthcare SC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 396 WI Yes

Addresses

Primary practice location

W180N8085 Town Hall Rd
3SW Suite 4
Menomonee Falls, WI 53051-3518

Mailing address

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Other identifiers

IdentifierTypeStateIssuer
42929500MedicaidWI
P00617883OtherWIRR MEDICARE

Other providers in Menomonee Falls, WI

All providers in Menomonee Falls, WI · Physician Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.