Active NPI
Nicholas Kriesel, PA-C, ATC
- Physician Assistant
- Pewaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- N15W28300 Golf Rd
Pewaukee, WI 53072-4800 - Phone
- (262) 303-5055
- NPI assigned
- Jul 14, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL4910 | FL | |
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Mailing address
10610 W Rogers St
West Allis, WI 53227-1247
Phone (414) 530-0928
Other practice location 1
3450 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 273-7001
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1231 S Rochester St
Suite 100
Mukwonago, WI 53149-9040
Phone (262) 303-5055
285 S Moorland Rd
Brookfield, WI 53005-4207
Phone (262) 303-5055
N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL4910 | FL | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Associates of Wisconsin SC | Current | Accepting new patients |
Locations
285 S Moorland Rd
Brookfield, WI 53005
Phone (810) 331-0939
1231 S Rochester St
Ste 100
Mukwonago, WI 53149
N15W28300 Golf Rd
Pewaukee, WI 53072
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Pewaukee, WI
- NPI 1689656951
-
- Orthopaedic Surgery Physician
- Mukwonago, WI
- NPI 1720433790
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oconomowoc, WI
- NPI 1366420531
-
dba ProHealth Pharmacy - Oconomowoc
- Community/Retail Pharmacy
- Oconomowoc, WI
- NPI 1497942205
Hospital
-
- General Acute Care Hospital
- Waukesha, WI
- NPI 1629056890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660694400000",
"number": "1649792235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10610 W ROGERS ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532271247",
"telephone_number": "414-530-0928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N15W28300 GOLF RD",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530724800",
"telephone_number": "262-303-5055"
}
],
"practiceLocations": [
{
"address_1": "3450 Hull Rd",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "FL",
"postal_code": "326074144",
"country_code": "US",
"telephone_number": "352-273-7001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRIESEL",
"first_name": "NICHOLAS",
"credential": "PA-C, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-14",
"last_updated": "2022-08-17",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL4910",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.