Individual provider Active NPI

Erin Hetland Mischke, PA

  • Physician Assistant
  • Powell, WY
National Provider Identifier
1811291172
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC908 Issued in KY
Practice address
777 Avenue H
Powell, WY 82435-2260
Phone
(307) 754-2267
NPI assigned
Dec 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC908 KY Primary
Physician Assistant 363A00000X 509 WY
Medical Physician Assistant 363AM0700X TL509 WY

Addresses

Primary practice location

777 Avenue H
Powell, WY 82435-2260

Mailing address

777 Avenue H
Powell, WY 82435-2260
Phone (307) 754-2267

Other practice location 1

120 N C Ave
Thermopolis, WY 82443-2410
Phone (307) 864-5534

Other practice location 2

2831 New Hartford Rd
Owensboro, KY 42303-1320
Phone (270) 926-4100

Other identifiers 1

IdentifierTypeStateIssuer
TL509OtherWYWY STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20221104001505 WY Practitioner - Physician Assistant 8628404308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.54 of 100Reported as group
Quality
71.68
Promoting interoperability
100
Improvement activities
40
Cost
70.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
509WYMDPhysical Therapy Assistant
TL509WYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Powell Valley Healthcare Inc CurrentSince Nov 15, 2022 Accepting new patients
Powell Valley Health Care Inc CurrentSince Nov 15, 2022 Accepting new patients

Locations

450 Mountain View St
Powell, WY 82435
Phone (307) 754-2267

777 Avenue H
Powell, WY 82435
Phone (307) 754-1175

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.

NPI Registry JSON

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1811291172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352260",
            "telephone_number": "307-754-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352260",
            "telephone_number": "307-754-2267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 N C Ave",
            "address_purpose": "LOCATION",
            "city": "Thermopolis",
            "state": "WY",
            "postal_code": "824432410",
            "country_code": "US",
            "telephone_number": "307-864-5534",
            "fax_number": "307-864-9470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2831 New Hartford Rd",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423031320",
            "country_code": "US",
            "telephone_number": "270-926-4100",
            "fax_number": "270-684-4678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISCHKE",
        "first_name": "ERIN",
        "middle_name": "HETLAND",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC908",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "509",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "TL509",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WY STATE LICENSE",
            "identifier": "TL509",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

Verify at the official NPI Registry.