ANNALISE M MATHISEN (PA-C) – Physician Assistant, NPI 1497309884

ANNALISE M MATHISEN (PA-C) is a healthcare provider. based in Appleton, Wisconsin. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 4758-23 (WI). The NPI Number for ANNALISE M MATHISEN (PA-C) is 1497309884

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
ANNALISE M MATHISEN (PA-C)
NPI
1497309884
Phone
(920) 996-3264
Address
122 E COLLEGE AVE
Enumeration Date
24 July 2019
Last Update Date
11 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9202768600
Graduation Year
2019 (7 years ago)
PAC ID
1254660293
Group Practice PAC ID
9436670916
Professional Enrollment ID
I20190917000975
Address ID
WI541159108DE1716XDRXX302

Contacts

Secure Messaging
akelsey323046@direct.myadvocateaurora.org
FHIR Endpoint
https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness95
Years active:6State licenses:1Other names

3,678 PHYSICIAN ASSISTANT in WI

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Provider Addresses for ANNALISE M MATHISEN (PA-C)

  • 122, East College Avenue, Appleton, Outagamie County, Wisconsin, 54911, United States

    APPLETON, WI 549115794

    Phone: (920) 996-3264

    Fax: (920) 830-5970

    Type: Mailing

  • ThedaCare Regional Medical Center-Neenah, 130, 2nd Street, Neenah, Winnebago County, Wisconsin, 54956, United States

    NEENAH, WI 549562883

    Phone: (920) 729-3100

    Type: Location

  • 1506 S Oneida St

    Appleton, WI 549151305

    Phone: (920) 632-6800

    Fax: (920) 632-6806

    Type: Location

  • 2700 W 9th Ave Ste 305

    Oshkosh, WI 549047865

    Phone: (920) 632-6800

    Fax: (920) 632-6806

    Type: Location

  • 1501 S Madison St

    Appleton, WI 549151846

    Phone: (920) 632-6800

    Fax: (920) 632-6806

    Type: Location

  • 500 S Oakwood Rd

    Oshkosh, WI 549047944

    Phone: (920) 632-6800

    Fax: (920) 632-6806

    Type: Location

  • 1540 Lyon Dr Ste 1

    Neenah, WI 549565037

    Phone: (920) 632-6800

    Fax: (920) 632-6806

    Type: Location

  • 614 Memorial Dr

    Chilton, WI 530141568

    Phone: (920) 632-6800

    Fax: (920) 632-6806

    Type: Location

  • 451 E Brooklyn St Ste 1

    Chilton, WI 530141595

    Phone: (920) 632-6800

    Fax: (920) 632-6806

    Type: Location

  • 3301 W FOREST HOME AVE

    MILWAUKEE, WI 532152843

    Phone:

    Type: Mailing

  • 855 N WESTHAVEN DR

    OSHKOSH, WI 549047668

    Phone: (920) 303-8700

    Type: Location

  • 1716 LAWRENCE DR STE 103

    DE PERE, WI 541159108

    Phone: (920) 632-6800

    Fax: (920) 632-6806

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $974.

Total Amount is formed as General ($974) + Research ($0) + Ownership ($0) = $974.

Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Medtronic, Inc. ($381).

Total Amount

$974

General + Research + Ownership

Payments

9

Total payment records

General Amount

$974

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-09-17

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190917000975IPhysician AssistantWITBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes9254$0
99215Established patient office or other outpatient visit, 40-54 minutes6542$0
62370Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician4412$0
76942Ultrasonic guidance for needle placement4412$0
62368Electronic analysis and reprogramming of spinal canal drug infusion pump4315$0
View full utilization report →

Insurance plans in this area (ZIP 54911)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436670916View full group profile
NameSpecialtyState
Pain Management, Anesthesiology, AnesthesiologyME
Nurse PractitionerWI
Anesthesiology, Pain ManagementWI
A N E S T H E S I O L O G YWI
Nurse PractitionerWI
Nurse PractitionerWI

Reviews

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Frequently asked questions

Can I verify ANNALISE M MATHISEN (PA-C) with an NPI only?
You can start verification with NPI 1497309884 for ANNALISE M MATHISEN (PA-C), then check state licensing separately.
Is ANNALISE M MATHISEN (PA-C) still practicing?
ANNALISE M MATHISEN (PA-C) is currently listed as active in the public NPI registry.
What is ANNALISE M MATHISEN (PA-C) best known for clinically?
Directory data describes ANNALISE M MATHISEN (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
What area does ANNALISE M MATHISEN (PA-C) serve?
ANNALISE M MATHISEN (PA-C)'s listing highlights Appleton, Wisconsin; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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