Individual provider Active NPI

Kelly Schneider, PA

  • Physician Assistant
  • Burlington, WI
National Provider Identifier
1376686006
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2074 Issued in WI
Practice address
248 McHenry St
Burlington, WI 53105-1828
Phone
(262) 767-8000
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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 085.008980 IL
Physician Assistant 363A00000X 2074 WI Primary

Addresses

Primary practice location

248 McHenry St
Burlington, WI 53105-1828

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1850 W Winchester Rd Ste 106
Libertyville, IL 60048-5355
Phone (847) 234-1177

Other practice location 2

925 Sherwood Dr
Lake Bluff, IL 60044-2203
Phone (847) 234-1177

Other identifiers 1

IdentifierTypeStateIssuer
42898500MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kschneider386006@direct.myadvocateaurora.org Direct

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
I20070320000116 WI Practitioner - Physician Assistant 8123121761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
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

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
2074WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc Physician Assistant CurrentSince Apr 2, 2007 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 20, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 20, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

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

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

3811 Spring St
Ste 301
Mount Pleasant, WI 53405
Phone (262) 687-6260

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Interoperability endpoints

  • Direct secure messaging: kschneider386006@direct.myadvocateaurora.org
  • Direct secure messaging: kschneider@directaddress.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1376686006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051828",
            "telephone_number": "262-767-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 W Winchester Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600485355",
            "country_code": "US",
            "telephone_number": "847-234-1177",
            "fax_number": "847-234-1875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 Sherwood Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Bluff",
            "state": "IL",
            "postal_code": "600442203",
            "country_code": "US",
            "telephone_number": "847-234-1177",
            "fax_number": "847-234-1875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "KELLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008980",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42898500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "248 McHenry St",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531051828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kschneider386006@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "248 McHenry St",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531051828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

Verify at the official NPI Registry.