ALISON M KETTERHAGEN (PA-C) – Physician Assistant, NPI 1083036123
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
3,703 PHYSICIAN ASSISTANT in WI
Provider Addresses for ALISON M KETTERHAGEN (PA-C)
3805B Spring St Ste 320
Mount Pleasant, WI 534051644
Phone: (303) 339-1499
Type: Location
3805B SPRING ST STE 320
MOUNT PLEASANT, WI 534051644
Phone:
Type: Mailing
PO BOX 735044
CHICAGO, IL 606735044
Phone: (800) 326-2250
Type: Mailing
10400 75TH ST
KENOSHA, WI 531427884
Phone: (262) 948-5600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $556.
Total Amount is formed as General ($556) + Research ($0) + Ownership ($0) = $556.
Last reported payment date: 2024-09-05 • Largest payer in this snapshot: Nevro Corp. ($398).
Total Amount
$556
General + Research + Ownership
Payments
8
Total payment records
General Amount
$556
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Nevro Corp. | $398 |
| SPR Therapeutics, Inc | $91 |
| TerSera Therapeutics LLC | $67 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-02-25
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190225000986 | I | Physician Assistant | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 144 | 83 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 51 | 40 | $0 |
| 76942 | Ultrasonic guidance for needle placement | 25 | 11 | $0 |
Insurance plans in this area (ZIP 53405)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WI | |
| Family Practice | WI | |
| Family Practice | IL | |
| Geriatric Medicine, Internal Medicine | WI | |
| - | WI | |
| - | WI | |
| - | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Family Practice | WI | |
| - | OH |
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