Individual provider Active NPI

Winston Harris II, PA-C

  • Physician Assistant
  • Middleton, WI
National Provider Identifier
1487417887
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
778523 Issued in WI
Practice address
8383 Greenway Blvd Ste 210
Middleton, WI 53562-3506
Phone
(608) 817-0965
NPI assigned
Jan 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 778523 WI
Physician Assistant 363A00000X 778523 WI Primary
Surgical Physician Assistant 363AS0400X 778523 WI

Addresses

Primary practice location

8383 Greenway Blvd Ste 210
Middleton, WI 53562-3506

Mailing address

8383 Greenway Blvd Ste 210
Middleton, WI 53562-3506
Phone (608) 831-1766

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
I20240423001604 WI Practitioner - Physician Assistant 1557700655 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
778523WIMDPhysician Assistant

Organizations & group practices 1

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1487417887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8383 GREENWAY BLVD STE 210",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623506",
            "telephone_number": "608-831-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8383 GREENWAY BLVD STE 210",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623506",
            "telephone_number": "608-817-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS II",
        "first_name": "WINSTON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "778523",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "778523",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "778523",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

Verify at the official NPI Registry.