Individual provider Active NPI

Alyssa Lebanowski, PA-C

  • Physician Assistant
  • Elkhorn, WI
National Provider Identifier
1407649080
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
W3985 County Road NN
Elkhorn, WI 53121-4337
Phone
(262) 741-2000
NPI assigned
May 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

W3985 County Road NN
Elkhorn, WI 53121-4337

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
100371310MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address arex416583@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
I20250922002215 WI Practitioner - Physician Assistant 2264936236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
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

W3985 County Rd NN
Elkhorn, WI 53121-4337
Phone (262) 741-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1407649080",
    "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": "W3985 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214337",
            "telephone_number": "262-741-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBANOWSKI",
        "first_name": "ALYSSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100371310",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "W3985 County Road Nn",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arex416583@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "W3985 County Road Nn",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

Verify at the official NPI Registry.