Individual provider Active NPI

Zachary Michael Rothenhoefer, PA

  • Physician Assistant
  • Hartford, WI
National Provider Identifier
1376209387
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7017 Issued in WI
Practice address
5729 Hwy 175
Hartford, WI 53027-9444
Phone
(262) 397-6887
NPI assigned
Nov 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 7017 WI Primary

Addresses

Primary practice location

5729 Hwy 175
Hartford, WI 53027-9444

Mailing address

5729 Hwy 175
Hartford, WI 53027-9444
Phone (262) 397-6887

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
I20220817003802 WI Practitioner - Physician Assistant 3476936873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1011 Spring City Dr
Suite 250
Waukesha, WI 53186-5934
Phone (262) 928-0370

1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

13900 W National Ave
New Berlin, WI 53151-9515
Phone (262) 928-4500

195 Discovery Dr
Brookfield, WI 53045-2862
Phone (262) 513-7100

2130 Big Bend Rd
Waukesha, WI 53189-7624
Phone (262) 928-7555

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900

2750 Golf Rd
Delafield, WI 53018-2062
Phone (262) 928-4900

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 Hospital, Waukesha, WI, CCN 520008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc CurrentSince Aug 1, 2022 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Aug 1, 2022 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

195 Discovery Dr
Brookfield, WI 53045
Phone (262) 513-7100

2750 Golf Rd
Delafield, WI 53018
Phone (262) 928-4900

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

13900 W National Ave
New Berlin, WI 53151
Phone (262) 928-4500

1185 Corporate Center Dr
Ste 175
Oconomowoc, WI 53066
Phone (262) 928-6236

1279 W Capitol Dr
Pewaukee, WI 53072
Phone (262) 928-9180

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

717 W Moreland Blvd
Waukesha, WI 53188
Phone (262) 542-9100

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

2130 Big Bend Rd
Waukesha, WI 53189
Phone (262) 928-7555

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

1011 Spring City Dr
Waukesha, WI 53186
Phone (262) 925-0370

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

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 1

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": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1376209387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5729 HWY 175",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530279444",
            "telephone_number": "262-397-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5729 HWY 175",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530279444",
            "telephone_number": "262-397-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHENHOEFER",
        "first_name": "ZACHARY",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-14",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, WI

Sources for this page

Verify at the official NPI Registry.