Liberty Joan Ansorge, PA-C
Physician Assistant in Milwaukee, WI. Individual provider (NPI-1).
NPI number1063370641
StatusActive
Last updated in NPPESJul 27, 2026
Details
- NPI
- 1063370641
- Entity type
- Individual (NPI-1)
- Name
- Liberty Joan Ansorge
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 13, 2026
- Certification date
- Jul 27, 2026
- Last updated
- Jul 27, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 8975-023 | WI | Yes |
Practice location
9200 W Wisconsin AveMilwaukee, WI 53226-3522
Phone 414-805-6850 · Fax 414-805-6864
Mailing address
9200 W Wisconsin AveMilwaukee, WI 53226-3522
Phone 414-805-6850 · Fax 414-805-6864
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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