Kelly Nicole Siverhus, PA-C, MS, RDN, CD is a medicare enrolled "Physician Assistant" provider in Milwaukee, Wisconsin. She graduated from medical school in 2024 and has 1 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice The Medical College Of Wisconsin Inc and her current practice location is
9200 W Wisconsin Ave, Milwaukee, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(414) 805-7782.
Kelly Nicole Siverhus is licensed to practice in Wisconsin (license number 8121-23) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1972269876.
Healthcare Provider's Profile
| Full Name | Kelly Nicole Siverhus |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 1 Years |
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| Location | 9200 W Wisconsin Ave, Milwaukee, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kelly Nicole Siverhus graduated from medical school in 2024
NPI Data:
- NPI Number: 1972269876
- Provider Enumeration Date: 11/15/2021
- Last Update Date: 12/13/2024
Medicare PECOS Information:
- PECOS PAC ID: 5294260733
- Enrollment ID: I20241121000806
Medical Identifiers
Medical identifiers for Kelly Nicole Siverhus such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1972269876 | NPI | - | NPPES |
| 1972269876 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 3755-29 (Wisconsin) | Secondary |
| 363A00000X | Physician Assistant | 8121-23 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| The Medical College Of Wisconsin Inc | 2668384371 | 1902 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Nicole Siverhus is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kelly Nicole Siverhus, PA-C, MS, RDN, CD
9200 W Wisconsin Ave,
Milwaukee, WI 53226-3522
Ph: (414) 805-7782 | Kelly Nicole Siverhus, PA-C, MS, RDN, CD
9200 W Wisconsin Ave,
Milwaukee, WI 53226-3522
Ph: (414) 805-7782 |
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