Anthony Thomas Hall, PA-C
Individual provider Active NPI Physician Assistant · Mukwonago, WI
NPI 1265926232 · NPPES record last updated Jun 20, 2025
Key facts
- NPI
- 1265926232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 4460-23 (WI)
- Practice address
- 240 Maple Ave
Mukwonago, WI 53149-8475 - Phone
- (262) 363-1900
- NPI assigned
- Jun 21, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prohealth Medical Group Inc
Practice addresses (Care Compare)
240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900
790 Cornerstone Xing
Waterford, WI 53185-4582
Phone (262) 363-1977
N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808
N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704
Hospital & facility affiliations
- Waukesha Memorial Hospital
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180912003009 | WI | Practitioner - Physician Assistant | 3072863042 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4460-23 | WI | MD | Physician Assistant |
| 4460 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc. | Current |
Accepting new patients | |
| Ascension Medical Group-Southeast Wisconsin Inc | Physician Assistant | Current |
Accepting new patients |
| Prohealth Medical Group Inc | Current |
Accepting new patients | |
| Prohealth Medical Group Inc | Past | Accepting new patients |
Locations
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
3807 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-8173
240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900
808 Cornerstone Ct
Waterford, WI 53185
Phone (262) 928-1977
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4460-23 | WI | Yes |
Addresses
Primary practice location
240 Maple Ave
Mukwonago, WI 53149-8475
Mailing address
240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 363-1900
Other practice location 1
808 Cornerstone Ct
Waterford, WI 53185-1503
Phone (262) 928-1977
Other providers in Mukwonago, WI
- Jeffrey D Gentile
- William Harry Green
- Collin Patrick Groves
- H.S. Psychological Services SC
- Lisa Haisler
- Kelly Elizabeth Halpin
- Rebecca Halverson
- Hammer Rehab & Fitness, LTD
- Kathryn L. Hammer
- Steven G Hammer
All providers in Mukwonago, WI · Physician Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.