Individual provider Active NPI

Brian Charles Dewitt, PA

  • Medical Physician Assistant
  • Minocqua, WI
National Provider Identifier
1184979676
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8014 Issued in WI
Practice address
9576 Hwy 70
Minocqua, WI 54548-9067
Phone
(715) 358-1803
Fax
(715) 358-1316
NPI assigned
Jul 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1766 MN
Medical Physician Assistant 363AM0700X 8014 WI Primary
Physician Assistant 363A00000X 11169 MN

Addresses

Primary practice location

9576 Hwy 70
Minocqua, WI 54548-9067

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5702
Phone (715) 387-5511

Other practice location 1

200 Elm St N
Onamia, MN 56359-7901
Phone (320) 532-3154

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120927000377 MN Practitioner - Physician Assistant 3375792815 Reassigns benefits to 5 organizations
I20241016002201 WI Practitioner - Physician Assistant 3375792815 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

9576 Hwy 70
Minocqua, WI 54548-9067
Phone (715) 358-1710

9969 Old Hwy 70
Minocqua, WI 54548-9010
Phone (715) 356-6016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1777MNMDMarriage & Family Therapist
11169MNMDPhysician Assistant
1766MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Mar 1, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 7, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 7, 2024 Accepting new patients
Mille Lacs Health System CurrentSince Sep 4, 2012 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 7, 2024 Accepting new patients
Fairview Health Services CurrentSince Aug 13, 2016 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 7, 2024 Accepting new patients
Fairview Clinics CurrentSince May 23, 2023 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Memorial Hospital Inc CurrentSince Oct 7, 2024 Accepting new patients
Fairview Clinics CurrentSince May 23, 2023 Accepting new patients
Mille Lacs Health System Current Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Aug 13, 2016 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Oct 7, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Oct 7, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 7, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Oct 7, 2024 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 1, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 7, 2024 Accepting new patients
Mille Lacs Health System Medical CurrentSince Sep 4, 2012 Accepting new patients
Mille Lacs Health System Medical Current Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

27378 State Highway 18
Garrison, MN 56450
Phone (320) 692-5599

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

9576 State Highway 70
Minocqua, WI 54548
Phone (715) 358-1000

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

2260 N Shore Dr
Rhinelander, WI 54501
Phone (715) 420-2379

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 28

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.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1184979676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495702",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9576 HWY 70",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489067",
            "telephone_number": "715-358-1803",
            "fax_number": "715-358-1316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Elm St N",
            "address_purpose": "LOCATION",
            "city": "Onamia",
            "state": "MN",
            "postal_code": "563597901",
            "country_code": "US",
            "telephone_number": "320-532-3154",
            "fax_number": "320-532-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "BRIAN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "1766",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "8014",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9576 Hwy 70",
            "city": "Minocqua",
            "state": "WI",
            "country_code": "US",
            "postal_code": "545489067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minocqua, WI

Sources for this page

Verify at the official NPI Registry.