NPIMap

Individual provider Active NPI

Katherine Lewis, PA-C

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1992102586
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3751-23 Issued in WI
Practice address
4111 N Port Washington Rd
Milwaukee, WI 53212-1029
Phone
(414) 299-3872
Fax
(414) 455-1929
NPI assigned
Nov 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 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 3751-23 WI Primary

Addresses

Primary practice location

4111 N Port Washington Rd
Milwaukee, WI 53212-1029

Mailing address

N24W24050 Brandon Oaks Dr Unit a
Pewaukee, WI 53072-6429
Phone (915) 873-9641

Other practice location 1

19115 W Capitol Dr Ste 117
Brookfield, WI 53045
Phone (262) 781-0240

Other identifiers 1

IdentifierTypeStateIssuer
PA.0004076OtherCOCOLORADO MEDICAL LICENSE

Other names 1

  • Katherine Fitzmayer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180728000050 WI Practitioner - Physician Assistant 3375866528 Reassigns benefits to 1 organization
I20220427000849 TX Practitioner - Physician Assistant 3375866528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

East Hwy 18
Pine Ridge, SD 57770-1201
Phone (605) 867-3032

P O Box
Suite 1201
Pine Ridge, SD 57770-1201

P O Box 1201 E Hwy 18
Pine Ridge, SD 57770-1201

PO Box 1201 E Hwy 18
Pine Ridge, SD 57770-1201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.82
Promoting interoperability
91
Improvement activities
40
Cost
84.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital CurrentSince Mar 23, 2022 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients

Locations

119 S 1st Ave
Martin, SD 57551
Phone (605) 685-2800

Organizations & group practices 4

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": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1992102586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N24W24050 BRANDON OAKS DR UNIT A",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530726429",
            "telephone_number": "915-873-9641",
            "fax_number": "262-373-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 N PORT WASHINGTON RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121029",
            "telephone_number": "414-299-3872",
            "fax_number": "414-455-1929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19115 W Capitol Dr Ste 117",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "53045",
            "country_code": "US",
            "telephone_number": "262-781-0240",
            "fax_number": "262-373-0148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3751-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO MEDICAL LICENSE",
            "identifier": "PA.0004076",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "FITZMAYER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.