Individual provider Active NPI

Kendra E Konitzer, PA

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1790194702
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3384 Issued in WI
Practice address
9200 W Wisconsin Ave
Gynecologic Oncology
Milwaukee, WI 53226-3522
Phone
(414) 805-8570
Fax
(414) 805-6622
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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 3384 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Gynecologic Oncology
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Gynecologic Oncology
Milwaukee, WI 53226-3522
Phone (414) 805-8570

Other identifiers 1

IdentifierTypeStateIssuer
1790194702MedicaidWI

Other names 1

  • Kendra E Bliese Former name

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
I20141002000545 WI Practitioner - Physician Assistant 5991925570 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Riverview Hospital and Clinics IncGroup PAC ID 4587658182, 166 clinicians

Practice addresses (Care Compare)

2031 Peach St
Wisconsin Rapids, WI 54494-5181
Phone (715) 423-0122

420 Dewey St
Wisconsin Rapids, WI 54494-4714
Phone (715) 422-7750

Hospital & facility affiliations

  • Aspirus Riverview Hospital & Clinics Inc Hospital, Wisconsin Rapids, WI, CCN 520033
  • Aspirus Stevens Point Hospital & Clinics, Inc. Hospital, Stevens Point, WI, CCN 520002

Merit-based Incentive Payment System (MIPS)

Final score
87.84 of 100Reported as group
Quality
86.21
Promoting interoperability
100
Improvement activities
40
Cost
73.25

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Nov 17, 2022 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Nov 17, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Marshfield Clinic Inc CurrentSince Jan 8, 2018 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Mar 3, 2021 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Mar 3, 2021 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/67ff075a-8289-4f2d-a8eb-5dc1f0d954ab/
  • Direct secure messaging: kkonitzer170766@direct.aspirus.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1790194702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "GYNECOLOGIC ONCOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8570",
            "fax_number": "414-805-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "GYNECOLOGIC ONCOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8570",
            "fax_number": "414-805-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONITZER",
        "first_name": "KENDRA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790194702",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "BLIESE",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.