KELLY PLAGEMANN (PA-C) – Physician Assistant, NPI 1992144265
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for KELLY PLAGEMANN (PA-C)
111 E WISCONSIN AVE
SUITE 2100
MILWAUKEE, WI 53202
Phone: (414) 290-6700
Fax: (414) 290-6755
Type: Mailing
2301 N LAKE DR
MILWAUKEE, WI 532114508
Phone: (414) 585-1200
Fax: (414) 290-6755
Type: Location
W129N7055 NORTHFIELD DR
MENOMONEE FALLS, WI 530510538
Phone: (262) 253-5400
Type: Mailing
1505 Wisconsin Ave Ste 150
Grafton, WI 530242075
Phone: (262) 421-8961
Type: Location
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: 2013-09-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (985 days ago).
Enrollment records
1
Earliest due date
2023-09-30
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 |
|---|---|---|---|---|
| I20130918000708 | I | Physician Assistant | WI | 2023-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 53202)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WI |
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