Emily Ann Lee, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3731-23 Issued in WI

Practice address

10400 75TH St Ste 215
Kenosha, WI 53142-7884

Phone

(262) 948-7380

NPI assigned

Feb 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Emily Ann Roberts Former name

Medicare fee-for-service enrollment

Enrolled in SD, 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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emily.roberts@avera.sdhealthlink.net

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.

• Group Health Cooperative of South Central Wisconsin

  • Health Maintenance Organization
  • Madison, WI
  • NPI 1245260165
  Medicare reassignment Care Compare group
• Avera McKennan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment
• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  • Obstetrics & Gynecology Physician
  • Sioux Falls, SD
  • NPI 1336111962
  NPD

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

• University of Wisconsin Hospitals and Clinics Authority

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1922043744
  Care Compare affiliation

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194097311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 75TH",
            "address_2": "STE 215",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531428323",
            "telephone_number": "262-948-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST STE 215",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-7380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1417 S. Cliff Ave.",
            "address_2": "Ste. 101",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051063",
            "country_code": "US",
            "telephone_number": "605-322-8937",
            "fax_number": "605-322-8938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0800",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3731-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6837080",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ROBERTS",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Lawler, DPT
• Carrie Jean Leber, APSW
• Corrie Ruth Lee, MSW, LCSW, SAC
• David Ansel Lee, DMD
• Drew Eunki Lee, M.D.
• Jennifer Lee
• Rand A Lee
• Ann Marie Leeder, FNP-BC
• Debra Lehocky
• Sandra Leicht, APNP

• Physician Assistant in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.