Kelsey Anne Defenbaugh, PA-C
Physician Assistant, Medical in Milwaukee, WI. Individual provider (NPI-1).
NPI number1265068993
StatusActive
Last updated in NPPESAug 7, 2020
Details
- NPI
- 1265068993
- Entity type
- Individual (NPI-1)
- Name
- Kelsey Anne Defenbaugh
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 13, 2020
- Certification date
- Aug 7, 2020
- Last updated
- Aug 7, 2020
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 |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 5019-23 | WI | Yes |
Practice location
9200 W Wisconsin AveMilwaukee, WI 53226-3522
Phone 414-805-4600 · Fax 414-805-2934
Mailing address
9200 W Wisconsin AveMilwaukee, WI 53226-3522
Phone 414-805-4600 · Fax 414-805-2934
Other practice locations
8701 W Watertown Plank Rd
Wauwatosa, WI 53226-3548
Wauwatosa, WI 53226-3548
Phone 414-805-4600
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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