Kathleen Anne Knipfer, P.A. C.

Individual provider Active NPI Physician Assistant · Cottage Grove, WI

NPI 1154586717 · NPPES record last updated Nov 2, 2020

Key facts

NPI
1154586717
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
2313-023 (WI)
Practice address
251 E Cottage Grove Rd
Cottage Grove, WI 53527-9619
Phone
(608) 839-3515
Fax
(608) 839-3541
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
Yes

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 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wildwood Family Clinic SC (27 clinicians)

Practice addresses (Care Compare)

4901 Cottage Grove Rd
Madison, WI 53716-1392
Phone (608) 221-1501

Hospital & facility affiliations

  • SSM Health St Mary'S Hospital - Madison Hospital · Madison, WI · CCN 520083
  • University of Wi Hospitals & Clinics Authority Hospital · Madison, WI · CCN 520098

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 IDStateProvider typePAC IDDetails
I20081007000146 WI Practitioner - Physician Assistant 4981772761 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2313-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Associates of Green Bay, S.C. Past Accepting new patients
Watertown Physician Practices LLC Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kknipfer261034@direct-ehr-ssmhc.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2313-023 WI Yes

Addresses

Primary practice location

251 E Cottage Grove Rd
Cottage Grove, WI 53527-9619

Mailing address

251 E Cottage Grove Rd
Cottage Grove, WI 53527-9619
Phone (608) 839-3515

Other identifiers

IdentifierTypeStateIssuer
1154586717MedicaidWI

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address kknipfer261034@direct-ehr-ssmhc.com Direct
FHIR URL https//fhir.ssmhc.com/fhir/api/FHIR/DSTU2 Other

Other providers in Cottage Grove, WI

All providers in Cottage Grove, WI · Physician Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.