Alyssa A Fibison, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7969 Issued in WI

Practice address

2116 Craig Rd
Eau Cliare, WI 54701

Phone

(715) 858-4610

NPI assigned

Jul 5, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Beaver Dam Community Hospitals Inc

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832
  Medicare reassignment NPD
• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• Memorial Hospital Inc

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• Flambeau Hospital Inc

  • Clinic/Center
  • Park Falls, WI
  • NPI 1194317966
  Medicare reassignment
• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment
• Flambeau Hospital Inc

  • Critical Access Hospital
  • Park Falls, WI
  • NPI 1700963048
  NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1427642255
  NPD
• MCHS Hospitals Inc

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1205569597",
    "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": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 CRAIG RD",
            "city": "EAU CLIARE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "715-858-4610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1208 119th Ave",
            "address_purpose": "LOCATION",
            "city": "Roberts",
            "state": "WI",
            "postal_code": "540231101",
            "country_code": "US",
            "telephone_number": "612-750-7097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIBISON",
        "first_name": "ALYSSA",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2116 CRAIG RD",
            "city": "Eau Cliare",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2116 CRAIG RD",
            "city": "Eau Cliare",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.