| Robert J Niles, PAC | |
|
265 Griffin St. East, Amery, WI 54001-1439 | |
| (715) 268-8000 | |
| (715) 268-0311 |
| Full Name | Robert J Niles |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 16 Years |
| Location | 265 Griffin St. East, Amery, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639488406 | NPI | - | NPPES |
| 1639488406 | Medicaid | WI | |
| 1639488406 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 2713-23 (Wisconsin) | Secondary |
| 363A00000X | Physician Assistant | 10827 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fairview Clinics | 7113830142 | 799 |
| North Memorial Health Care | 0042123028 | 502 |
| Entity Name | Fairview Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811077175 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
| Entity Name | Fairview Clinics |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346432218 PECOS PAC ID: 7113830142 Enrollment ID: O20031106000516 |
| Entity Name | Healtheast Medical Research Institute |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639125503 PECOS PAC ID: 3971407636 Enrollment ID: O20031124000507 |
| Entity Name | North Memorial Health Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851344907 PECOS PAC ID: 0042123028 Enrollment ID: O20040122000470 |
| Entity Name | Fairview Express Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548 |
| Mailing Address | Practice Location Address |
|---|---|
| Robert J Niles, PAC 265 Griffin St. East, Amery, WI 54001-1439 Ph: (715) 268-8000 | Robert J Niles, PAC 265 Griffin St. East, Amery, WI 54001-1439 Ph: (715) 268-8000 |
Anna Walker, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 265 Griffin St E, Amery, WI 54001 Phone: 715-268-8000 |
Kailey M Ledo, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 265 Griffin St E, Amery, WI 54001 Phone: 715-268-8000 |