NPIMap

Individual provider Active NPI

Aaron Witt

  • Physician Assistant
  • North Fond Du Lac, WI
National Provider Identifier
1578047452
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4514-23 Issued in WI
Practice address
700 Park Ridge LN
North Fond Du Lac, WI 54937-1385
Phone
(920) 926-7800
NPI assigned
Sep 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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 4514-23 WI Primary

Addresses

Primary practice location

700 Park Ridge LN
North Fond Du Lac, WI 54937-1385

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (920) 926-7800

Other practice location 1

2710 Executive Dr
Green Bay, WI 54304-5496
Phone (920) 496-4700

Other identifiers 2

IdentifierTypeStateIssuer
4514-23OtherWIPHYSICIAN ASSISTANT LICENSE
100082076MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address awitt369384@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181022001322 WI Practitioner - Physician Assistant 3678826609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

700 Park Ridge LN
North Fond Du Lac, WI 54937-1385
Phone (920) 926-7800

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

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 Apr 18, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 18, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

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

700 Park Ridge Ln
North Fond du Lac, WI 54937
Phone (920) 907-7450

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

Interoperability endpoints

  • Direct secure messaging: awitt369384@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 8

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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1578047452",
    "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": "920-926-7800",
            "fax_number": "920-921-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PARK RIDGE LN",
            "city": "NORTH FOND DU LAC",
            "state": "WI",
            "postal_code": "549371385",
            "telephone_number": "920-926-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2710 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543045496",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITT",
        "first_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-18",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4514-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "4514-23",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100082076",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awitt369384@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "700 Park Ridge Ln",
            "city": "North Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549371385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "700 Park Ridge Ln",
            "city": "North Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549371385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.