Individual provider Active NPI

Laura A Huebel, P.A.

  • Physician Assistant
  • Jefferson, WI
National Provider Identifier
1912986209
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1290 Issued in WI
Practice address
W5843 Gehler Rd
Jefferson, WI 53549-9662
Phone
(414) 759-4119
NPI assigned
Jan 13, 2006
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1290 WI Primary
Medical Physician Assistant 363AM0700X 1290-23 WI

Addresses

Primary practice location

W5843 Gehler Rd
Jefferson, WI 53549-9662

Mailing address

W5843 Gehler Rd
Jefferson, WI 53549-9662
Phone (414) 759-4119

Other identifiers 1

IdentifierTypeStateIssuer
41982900MedicaidWI

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
I20040510000669 WI Practitioner - Physician Assistant 2668461203 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1011 Spring City Dr
Suite 250
Waukesha, WI 53186-5934
Phone (262) 928-0370

109 Air Park Dr
Watertown, WI 53094-7400
Phone (262) 928-5100

1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

1279 W Capitol Dr
Pewaukee, WI 53072-2504
Phone (262) 928-9180

13900 W National Ave
New Berlin, WI 53151-9515
Phone (262) 928-4500

195 Discovery Dr
Brookfield, WI 53045-2862
Phone (262) 513-7100

2130 Big Bend Rd
Waukesha, WI 53189-7624
Phone (262) 928-7555

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900

2750 Golf Rd
Delafield, WI 53018-2062
Phone (262) 928-4900

790 Cornerstone Xing
Waterford, WI 53185-4582
Phone (262) 363-1977

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1290-23WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Jan 1, 2021 Accepting new patients
Prohealth Medical Group Inc CurrentSince Jan 1, 2021 Accepting new patients
Reedsburg Area Medical Center Inc CurrentSince Nov 15, 2018 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Nov 15, 2018 Accepting new patients
Astia Health Clinical Services, SC Past Accepting new patients

Locations

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

808 Cornerstone Xing
Waterford, WI 53185
Phone (262) 500-5292

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

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.

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1912986209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5843 GEHLER RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499662",
            "telephone_number": "414-759-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W5843 GEHLER RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499662",
            "telephone_number": "414-759-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUEBEL",
        "first_name": "LAURA",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1290",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1290-23",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41982900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

Verify at the official NPI Registry.