Individual provider Active NPI

Alexandra Claire Klippel, PA-C

  • Physician Assistant
  • Green Bay, WI
National Provider Identifier
1730836560
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7156-23 Issued in WI
Practice address
720 S Vanburen St
Green Bay, WI 54301-3504
Phone
(920) 468-3444
Fax
(920) 432-6313
NPI assigned
Mar 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 7156-23 WI Primary

Addresses

Primary practice location

720 S Vanburen St
Green Bay, WI 54301-3504

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other practice location 1

704 S Webster Ave
Green Bay, WI 54301-3528
Phone (920) 338-6868

Other practice location 2

1419 Salt Springs Rd
Syracuse, NY 13214-1302
Phone (315) 445-4100

Other identifiers 1

IdentifierTypeStateIssuer
1198942OtherNATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS

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
I20230124001133 WI Practitioner - Physician Assistant 1254702509 Reassigns benefits to 1 organization

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
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505

720 S Van Buren St
Green Bay, WI 54301-3534

720 S Vanburen St
Suite 201
Green Bay, WI 54301-3534
Phone (920) 433-7488

744 S Webster Ave
Green Bay, WI 54301-3505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7156-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Jan 10, 2023 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jan 10, 2023 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients
Bellin Psychiatric Center Inc. PastSince Jan 15, 2023 Accepting new patients

Locations

704 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-3784

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

720 S Van Buren St
Ste 101
Green Bay, WI 54301
Phone (920) 430-8120

Interoperability endpoints

  • Direct secure messaging: aklippel926305@direct.emplifyhealth.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 1

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": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1730836560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S VANBUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013504",
            "telephone_number": "920-468-3444",
            "fax_number": "920-432-6313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013528",
            "country_code": "US",
            "telephone_number": "920-338-6868",
            "fax_number": "920-338-6869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1419 Salt Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132141302",
            "country_code": "US",
            "telephone_number": "315-445-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLIPPEL",
        "first_name": "ALEXANDRA",
        "middle_name": "CLAIRE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7156-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN  ASSISTANTS",
            "identifier": "1198942",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.