Individual provider Active NPI

Kevin Erdman, PA-C

  • Physician Assistant
  • Salem, WI
National Provider Identifier
1275723157
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1161-23 Issued in WI
Practice address
25320 75TH St
Salem, WI 53168-9684
Phone
(262) 843-2336
NPI assigned
Jul 27, 2007
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1161-23 WI Primary
Medical Physician Assistant 363AM0700X 1161-023 WI

Addresses

Primary practice location

25320 75TH St
Salem, WI 53168-9684

Mailing address

25320 75TH St
Salem, WI 53168-9684
Phone (262) 843-2336

Other practice location 1

1446 N Randall Ave
Janesville, WI 53545-1122
Phone (608) 758-7215

Other identifiers 1

IdentifierTypeStateIssuer
32789100MedicaidWI

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address kerdman259671@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api.FHIR/DSTU2/ Other
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kerdman356463@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 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
I20080130000161 WI Practitioner - Physician Assistant 9133201130 Reassigns benefits to 5 organizations
I20200415001466 IL Practitioner - Physician Assistant 9133201130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

146 E Geneva SQ
Lake Geneva, WI 53147-9694
Phone (262) 249-5000

201 E Morrissey Dr
Elkhorn, WI 53121-4395
Phone (262) 723-3100

248 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-8000

252 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1161-23WIMDPhysician Assistant
1161-023WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Dec 5, 2022 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 5, 2022 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Dec 5, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 11, 2022 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 5, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince Apr 11, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 11, 2022 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

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

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

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

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

9601 Townline Rd
Minocqua, WI 54548
Phone (715) 358-1000

25320 75th St
Salem, WI 53168
Phone (262) 243-2336

725 American Ave
#5
Waukesha, WI 53188
Phone (262) 928-2475

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/67ff075a-8289-4f2d-a8eb-5dc1f0d954ab/
  • Direct secure messaging: kevin.erdman@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1275723157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25320 75TH ST",
            "city": "SALEM",
            "state": "WI",
            "postal_code": "531689684",
            "telephone_number": "262-843-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25320 75TH ST",
            "city": "SALEM",
            "state": "WI",
            "postal_code": "531689684",
            "telephone_number": "262-843-2336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1446 N Randall Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535451122",
            "country_code": "US",
            "telephone_number": "608-758-7215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERDMAN",
        "first_name": "KEVIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1161-23",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1161-023",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32789100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kerdman259671@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kerdman259671@direct-ehr-ssmhc.com",
            "address_1": "1223 E Main St",
            "city": "Perry",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634621410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api.FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1223 E Main St",
            "city": "Perry",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634621410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kerdman356463@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, WI

Sources for this page

Verify at the official NPI Registry.