Kelsey G Alt, PA
Individual provider Active NPI Medical Physician Assistant · Madison, WI
NPI 1366097040 · NPPES record last updated Jan 5, 2024
Key facts
- NPI
- 1366097040
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 4820 (WI)
- Practice address
- 600 Highland Ave
Madison, WI 53792-3454 - Phone
- (608) 263-6400
- Fax
- (608) 234-4383
- NPI assigned
- Aug 8, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Wisconsin Medical Foundation Inc
Practice addresses (Care Compare)
4602 Eastpark Blvd
Madison, WI 53718-2002
Phone (608) 440-6400
600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400
Hospital & facility affiliations
- University of Wi Hospitals & Clinics Authority
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 |
|---|---|---|---|---|
| I20190913001569 | WI | Practitioner - Physician Assistant | 8820327034 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4820 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Wisconsin Medical Foundation, Inc | Current |
Accepting new patients | |
| University of Wisconsin Medical Foundation, Inc | Current |
Accepting new patients | |
| Thedacare, Incorporated | Current |
Accepting new patients | |
| University of Wisconsin Medical Foundation Inc | Past | Accepting new patients |
Locations
122 E College Ave
Appleton, WI 54911
Phone (920) 996-3264
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325
7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270
3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229
1405 Mill St
New London, WI 54961
Phone (920) 531-2000
600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4820 | WI | |
| Medical Physician Assistant | 363AM0700X | 4820 | WI | Yes |
Addresses
Primary practice location
600 Highland Ave
Madison, WI 53792-3454
Mailing address
7974 Uw Health CT
Middleton, WI 53562-5531
Other providers in Madison, WI
- Wejdan Alseqami
- Eman Alshaikh
- James David Alstott
- Harlee J Alsum
- Pamela B Alsum
- Robert L Alt
- Corinne Altamira
- Michael M Altaweel
- Alteas Health Pulmonary of Wisconsin S.C.
- Altegra Health Connections, LLC
All providers in Madison, WI · Medical 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 Jan 5, 2024. 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.