Individual provider Active NPI

Benjamin Ziebart, PA-C

  • Physician Assistant
  • West Allis, WI
National Provider Identifier
1205320074
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4597-23 Issued in WI
Practice address
7516 W Oklahoma Ave
West Allis, WI 53219-2860
Phone
(414) 885-0456
Fax
(414) 885-0720
NPI assigned
Jun 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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 4597-23 WI Primary

Addresses

Primary practice location

7516 W Oklahoma Ave
West Allis, WI 53219-2860

Mailing address

2901 W Kinnickinnic River Pkwy Ste 305
Milwaukee, WI 53215-3660
Phone (414) 649-6000

Other practice location 1

N19W28072 Golf View Ct
Pewaukee, WI 53072-5170
Phone (262) 443-7912

Other practice location 2

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 649-6000

Other practice location 3

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 649-6000

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
I20190313000346 WI Practitioner - Physician Assistant 8123368073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisconsin Bone and Joint S CGroup PAC ID 9234107749, 21 clinicians

Practice addresses (Care Compare)

2500 N Mayfair Rd
Wauwatosa, WI 53226-1415
Phone (414) 257-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4597-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Bone & Joint S C CurrentSince Dec 9, 2024 Accepting new patients
West Allis Urgent Care Walk in Clinic Corp CurrentSince Jun 24, 2021 Accepting new patients
Froedtert South, Inc. CurrentSince Apr 15, 2024 Accepting new patients

Locations

525 W River Woods Pkwy
Ste 130
Glendale, WI 53212
Phone (414) 961-0304

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

2500 N Mayfair Rd
Ste 500
Wauwatosa, WI 53226
Phone (414) 257-1772

2500 N Mayfair Rd
Ste 550
Wauwatosa, WI 53226
Phone (414) 257-2525

7516 W Oklahoma Ave
West Allis, WI 53219
Phone (414) 885-0456

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.

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1205320074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 305",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-649-6000",
            "fax_number": "414-649-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7516 W OKLAHOMA AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532192860",
            "telephone_number": "414-885-0456",
            "fax_number": "414-885-0720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N19W28072 Golf View Ct",
            "address_purpose": "LOCATION",
            "city": "Pewaukee",
            "state": "WI",
            "postal_code": "530725170",
            "country_code": "US",
            "telephone_number": "262-443-7912",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53215",
            "country_code": "US",
            "telephone_number": "414-649-6000",
            "fax_number": "414-649-5296",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53215",
            "country_code": "US",
            "telephone_number": "414-649-6000",
            "fax_number": "414-649-5296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIEBART",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4597-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.