Julia Nicole Mennen, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1511 Issued in WI

Practice address

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203

Phone

(414) 672-1353

Fax

(414) 672-4265

NPI assigned

Jun 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Julia Nicole Mickey, Rewolinski Professional name

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

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

16TH Street Community Health Center Inc.Group PAC ID 6709876857, 83 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmennen354316@direct.ochin.org

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.

• 16TH Street Community Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1417912999
  Medicare reassignment Care Compare group
• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1316587439

  Physician Assistant

  NPD
• Sixteenth Street Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1821517681
  NPD

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407852916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "telephone_number": "414-672-1353",
            "fax_number": "414-672-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "telephone_number": "414-672-1353",
            "fax_number": "414-672-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENNEN",
        "first_name": "JULIA",
        "middle_name": "NICOLE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "39280350003",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41972400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "MICKEY, REWOLINSKI",
            "middle_name": "NICOLE",
            "credential": "P.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ronald T. Mendyke, MSW, LCSW
• Dylan Henry Menefee, PA-C
• Ellen Menefee, P.A.
• Ulviye Menekseoglu, CAA
• Dalton Stephen Menke, PA-C
• Anjali Rajan Menon, AA-C
• Elizabeth A Menon, LPC
• James Menor, DPT
• Ment Always by Your Side
• Mental Health America of Wisconsin

• Physician Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.