Kevin T Wyne, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2909-23 Issued in WI

Practice address

600 Highland Ave
Madison, WI 53792-0001

Phone

(608) 262-2398

NPI assigned

Nov 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

Electronic endpoints 2

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Madison Emergency Physicians SCGroup PAC ID 4587631858, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057

Merit-based Incentive Payment System (MIPS)

Final score

79.19 of 100Reported as group

Quality

74.01

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwyne264237@direct-ehr-ssmhc.com

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.

• Madison Emergency Physicians, SC

  • Emergency Medicine Physician
  • Madison, WI
  • NPI 1588646095
  Medicare reassignment Care Compare group
• Prairie Ridge Health, Inc.

  • Critical Access Hospital
  • Columbus, WI
  • NPI 1841376183
  Medicare reassignment
• Upland Hills Health Inc

  dba Upland Hills Health Center

  • Surgery Physician
  • Dodgeville, WI
  • NPI 1821258740
  Medicare reassignment
• Prairie Ridge Health Inc.

  dba Prairie Ridge Health Clinic-Sun Prairie

  • Family Medicine Physician
  • Sun Prairie, WI
  • NPI 1699534545
  NPD
• Prairie Ridge Health, Inc.

  • Orthopaedic Surgery Physician
  • Columbus, WI
  • NPI 1912329335
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care of Wisconsin Inc

  dba SSM Health St Clare Hospital-Baraboo

  • General Acute Care Hospital
  • Baraboo, WI
  • NPI 1386641207
  Care Compare affiliation

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1699757880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-262-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNE",
        "first_name": "KEVIN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001734",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0030930",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085002558",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2909-23",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002558",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100024390",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "28783",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwyne362157@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "600 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537920001",
            "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": "600 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537920001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Joy Wunschel, BCBA
• Alena Wurster, MD
• Beth Wurth, OTR/L
• Tracie L Wuthrich, PTA
• Laura Brichler Wyatt, AA-C
• Morgan A Wynes, PHARMD
• Martha M Wynn, MD
• Madelyn Wynveen
• Yu Xia, MD
• Cindy Xiao, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.