AUTUMN R MILLER (PA-C) – Physician Assistant, NPI 1093023319
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,672 PHYSICIAN ASSISTANT in WI
Provider Addresses for AUTUMN R MILLER (PA-C)
2601 FIELDCREST DR
KAUKAUNA, WI 541304523
Phone: (920) 462-6100
Fax: (920) 462-6107
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2011-03-07
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20110307000909 | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 64 | 34 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 52 | 35 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 27 | 27 | $0 |
Insurance plans in this area (ZIP 54130)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | WI | 85610 | Blood test, clotting time | 110 | 28 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | MI | |
| General Surgery | WI | |
| - | WI | |
| Nurse Practitioner | WI | |
| - | IL | |
| O P H T H A L M O L O G Y | WI | |
| - | OH | |
| - | WI | |
| - | WI | |
| - | WI |
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