NPIMap

Individual provider Active NPI

Eve J. Komosa, PA-C

  • Physician Assistant
  • Ironwood, MI
National Provider Identifier
1609214600
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006694 Issued in MI
Practice address
N. 10561 Grand View Lane
Aspirus Grand View
Ironwood, MI 49938
Phone
(906) 932-1500
NPI assigned
Jun 12, 2013
Last updated
Jun 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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 5601006694 MI Primary

Addresses

Primary practice location

N. 10561 Grand View Lane
Aspirus Grand View
Ironwood, MI 49938

Mailing address

3821 Tulane Ave
Madison, WI 53714-2954
Phone (608) 630-1522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130913000104 MI Practitioner - Physician Assistant 9638313661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Ironwood Hospital and Clinics IncGroup PAC ID 9032013198, shared by 5 NPIs, 165 clinicians

Practice addresses (Care Compare)

N10561 Grandview LN
Ironwood, MI 49938-9622
Phone (906) 932-2525

N10561 Granview LN
Grand View Hospital
Ironwood, MI 49938-9622
Phone (906) 932-2525

N10565 Grand View Lane
Ironwood, MI 49938-9622

N10565 Grandview Lane
Ironwood, MI 49938-9622

N10565 Grandview LN Aspirus Ironwood
Ironwood, MI 49938-9622
Phone (715) 843-1067

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601006694MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince Jul 15, 2013 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince Jul 15, 2013 Accepting new patients
Vickers Eyecare, Inc PastSince Jul 1, 2020 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

N10565 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

9815 State Highway 70
Minocqua, WI 54548
Phone (715) 358-3937

Interoperability endpoints

  • Direct secure messaging: ekomosa63893@direct.aspirus.org

Organizations & group practices 4

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 10

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1609214600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 TULANE AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537142954",
            "telephone_number": "608-630-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N. 10561 GRAND VIEW LANE",
            "address_2": "ASPIRUS GRAND VIEW",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "49938",
            "telephone_number": "906-932-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOSA",
        "first_name": "EVE",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ironwood, MI

Sources for this page

Verify at the official NPI Registry.