Individual provider Active NPI

Catherine Powers Zellmer, PA

  • Physician Assistant
  • Mequon, WI
National Provider Identifier
1861754715
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2948 Issued in WI
Practice address
13133 N Port Washington Rd
Suite G-16
Mequon, WI 53097-2419
Phone
(262) 243-2500
Fax
(262) 243-5395
NPI assigned
Jun 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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 2948 WI Primary

Addresses

Primary practice location

13133 N Port Washington Rd
Suite G-16
Mequon, WI 53097-2419

Mailing address

788 N Jefferson St
Suite 300/Attn. Kaaren Butzen
Milwaukee, WI 53202-3718
Phone (414) 272-8950

Other identifiers 1

IdentifierTypeStateIssuer
1861754715MedicaidWI

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
I20120726000426 WI Practitioner - Physician Assistant 3072779685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300

2301 N Lake Dr
Milwaukee, WI 53211-4508

2323 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 585-1000

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2948WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Feb 6, 2024 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Feb 6, 2024 Accepting new patients

Locations

13133 N Port Washington Rd
Ste G16
Mequon, WI 53097
Phone (262) 243-2500

13133 N Port Washington Rd
Ste G01
Mequon, WI 53097
Phone (262) 243-2500

788 N Jefferson St
Ste 300ATTN
Milwaukee, WI 53202

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

788 N Jefferson St
Ste 401
Milwaukee, WI 53202
Phone (414) 226-4020

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

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.

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1861754715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST",
            "address_2": "SUITE 300/ATTN. KAAREN BUTZEN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023718",
            "telephone_number": "414-272-8950",
            "fax_number": "414-272-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13133 N PORT WASHINGTON RD",
            "address_2": "SUITE G-16",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972419",
            "telephone_number": "262-243-2500",
            "fax_number": "262-243-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLMER",
        "first_name": "CATHERINE",
        "middle_name": "POWERS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861754715",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.