Individual provider Active NPI

Debra L Kneisler, PAC

  • Physician Assistant
  • West Allis, WI
National Provider Identifier
1902879810
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1392 Issued in WI
Practice address
8905 W Lincoln Ave
West Allis, WI 53227-2468
Phone
(414) 329-5656
Fax
(414) 329-5939
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 1392 WI Primary

Addresses

Primary practice location

8905 W Lincoln Ave
West Allis, WI 53227-2468

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 1

IdentifierTypeStateIssuer
41932800MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dkneisler31735@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20040910000023 WI Practitioner - Physician Assistant 9436125424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

13250 Washington Ave
Mount Pleasant, WI 53177-1516
Phone (262) 884-4000

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5930

8905 W Lincoln Ave
West Allis, WI 53227-2468
Phone (414) 328-8480

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139
  • Aurora Medical Center - Summit Hospital, Summit, WI, CCN 520206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1392WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. CurrentSince Mar 30, 2016 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2009 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Mar 30, 2016 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2009 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

2845 Greenbrier Rd
#4
Green Bay, WI 54311
Phone (920) 288-8400

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

950 N 12th St
Milwaukee, WI 53233
Phone (414) 219-6036

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

2801 W Kinnickinnic River Pkwy
Ste 540
Milwaukee, WI 53215
Phone (414) 385-2429

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

915 Summit Ave
Summit, WI 53066
Phone (262) 569-2300

8905 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

8905 W Lincoln Ave
Ste 407
West Allis, WI 53227
Phone (414) 545-8808

Organizations & group practices 6

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 5

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1902879810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272468",
            "telephone_number": "414-329-5656",
            "fax_number": "414-329-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEISLER",
        "first_name": "DEBRA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41932800",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkneisler31735@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2745 W Layton Ave",
            "address_2": "Suite 206",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532212651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2745 W Layton Ave",
            "address_2": "Suite 206",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532212651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.