Marisa K Miller, - Medicare Physician Assistant in Kenosha, WI

Marisa K Miller, is a medicare enrolled "Physician Assistant" in Kenosha, Wisconsin. Her current practice location is 10400 75th St Ste 315, Kenosha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 948-7815.

Marisa K Miller is licensed to practice in Wisconsin (license number 7129-23) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083311534.

Contact Information

Marisa K Miller,
10400 75th St Ste 315,
Kenosha, WI 53142-7884
(262) 948-7815
Not Available



Provider's Profile

Full NameMarisa K Miller
GenderFemale
SpecialityPhysician Assistant
Location10400 75th St Ste 315, Kenosha, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1083311534
  • Provider Enumeration Date: 02/14/2023
  • Last Update Date: 01/02/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3072988377
  • Enrollment ID: I20230418001243

Medical Identifiers

Medical identifiers for Marisa K Miller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083311534NPI-NPPES
100234029MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 7129-23 (Wisconsin)Primary

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. Marisa K Miller 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 AddressPractice Location Address
Marisa K Miller,
Po Box 735044,
Chicago, IL 60673-5044

Ph: (800) 326-2250
Marisa K Miller,
10400 75th St Ste 315,
Kenosha, WI 53142-7884

Ph: (262) 948-7815

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Physician Assistant Nurses in Kenosha, WI

David B Kite, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 10400 75th St, Kenosha, WI 53142
Phone: 262-948-7000    
William T Merritt, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 6121 Green Bay Rd Ste 100, Kenosha, WI 53142
Phone: 262-945-7557    Fax: 262-727-0841
Miss Sarah Rens, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 6308 8th Ave, Kenosha, WI 53143
Phone: 262-656-3590    Fax: 262-656-3591
Ms. Amber D Devine, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 7401 104th Ave, Suite 110, Kenosha, WI 53142
Phone: 262-764-5595    Fax: 262-764-9314
Jeffrey Allen Greene, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 10400 75th St, Kenosha, WI 53142
Phone: 262-948-6770    
Michelle R Nelson, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 6308 8th Ave, Suite 505, Kenosha, WI 53143
Phone: 262-656-3525    Fax: 262-656-3560
Nadya M Modlin, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 10400 75th St, Emergency Department, Kenosha, WI 53142
Phone: 262-948-7000    

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