Individual provider Active NPI

Gabriella Medeiros Ducheny

  • Medical Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1962391102
Registry record updated Aug 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
507 N 17TH St
Milwaukee, WI 53233-2104
Phone
(414) 288-5688
NPI assigned
Jul 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

507 N 17TH St
Milwaukee, WI 53233-2104

Mailing address

507 N 17TH St
Milwaukee, WI 53233-2104

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
I20260622001477 WI Practitioner - Physician Assistant 5698248771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10625 W N Ave
Suite 101
Milwaukee, WI 53226-2315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755388800000",
    "number": "1962391102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N 17TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N 17TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332104",
            "telephone_number": "414-288-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS DUCHENY",
        "first_name": "GABRIELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-08-17",
        "certification_date": "2025-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.