| Carly Diane Triebensee, PA | |
|
N2950 State Road 67, Lake Geneva, WI 53147-2655 | |
| (262) 245-0535 | |
| Not Available |
| Full Name | Carly Diane Triebensee |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | N2950 State Road 67, Lake Geneva, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093548984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | 8106-23 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Health System Corp | Janesville, WI | Hospital |
| Mercy Walworth Hospital & Medical Center | Lake geneva, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Health System Corporation | 7416860440 | 749 |
| Entity Name | Mercy Health System Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031113000164 |
| Entity Name | Mercy Health System Corporation |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1699728550 PECOS PAC ID: 7416860440 Enrollment ID: O20210611000108 |
| Mailing Address | Practice Location Address |
|---|---|
| Carly Diane Triebensee, PA 9615 Harvest Moon Ln Apt 413, Verona, WI 53593-9676 Ph: (920) 946-9353 | Carly Diane Triebensee, PA N2950 State Road 67, Lake Geneva, WI 53147-2655 Ph: (262) 245-0535 |
Michelle R Nelson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 146 E Geneva Sq, Lake Geneva, WI 53147 Phone: 262-249-5000 |
Marianne T Weber, PAC Physician Assistant Medicare: Medicare Enrolled Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 |
Natalie J Ellingson, PAC Physician Assistant Medicare: Medicare Enrolled Practice Location: 146 E Geneva Sq, Lake Geneva, WI 53147 Phone: 262-843-4422 |
Dr. Christopher S Schmidt, MD Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-0535 |
Ms. Annette M Husske, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 146 E Geneva Sq, Lake Geneva, WI 53147 Phone: 262-249-5000 |
Sarah L Pieper, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: N2950 State Road 67, Lake Geneva, WI 53147 Phone: 262-245-4990 Fax: 262-245-2248 |
James William Gelder, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 146 E Geneva Sq, Lake Geneva, WI 53147 Phone: 262-249-5000 |