Individual provider Active NPI

Caroline Cibulka, PA-C

  • Physician Assistant
  • Waukesha, WI
National Provider Identifier
1740153444
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
N20W22961 Watertown Rd
Waukesha, WI 53186-1308
Phone
(262) 875-5070
Fax
(866) 384-9486
NPI assigned
Sep 29, 2025
Last updated
Sep 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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 WI Primary

Addresses

Primary practice location

N20W22961 Watertown Rd
Waukesha, WI 53186-1308

Mailing address

N20W22961 Watertown Rd
Waukesha, WI 53186-1308
Phone (262) 875-5070

Other practice location 1

1400 8th Ave
Union Grove, WI 53182-1063
Phone (262) 875-5070

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
I20251212001915 WI Practitioner - Physician Assistant 1153815543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Medical SCGroup PAC ID 0042595175, 118 clinicians

Practice addresses (Care Compare)

1451 Cleveland Ave
Waukesha, WI 53186-3876
Phone (262) 547-2123

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Medical SC CurrentSince Jan 1, 2026 Accepting new patients

Locations

1451 Cleveland Ave
Waukesha, WI 53186
Phone (262) 547-2123

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1740153444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861308",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N20W22961 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861308",
            "telephone_number": "262-875-5070",
            "fax_number": "866-384-9486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Union Grove",
            "state": "WI",
            "postal_code": "531821063",
            "country_code": "US",
            "telephone_number": "262-875-5070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIBULKA",
        "first_name": "CAROLINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.