MRS. ALYSSA M RICCHIO (NPI# 1629364815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629364815 |
| Entity Type | Individual |
| Full Name | MRS. ALYSSA M RICCHIO |
| Other Name | ALYSSA M WILSON |
| Credential | PA-C |
| Practice Address |
10400 75th St Ste 700 Kenosha WI 53142-7884 |
| Practice Telephone | 2629486618 |
| Mailing Telephone | 2629486618 |
| Enumeration Date | 2011-06-26 |
| Last Update Date | 2018-01-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2769-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1629364815 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4536 22nd Ave, Kenosha, WI 531405917 | 2626560044 |
| Street Address |
10400 75TH ST STE 700 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-7884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548632219 | Kim Doan Gilbert | Nurse Practitioner | 10400 75th St Ste 700, Kenosha, WI 53142-7884 | 2015-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043843592 | Brian Owings | Physician Assistant | 3400 Market Ln # 300, Kenosha, WI 53144-3430 | 2020-02-12 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1215311881 | Sarah Ann Moony | Physician Assistant | 8500 75th St Ste 102, Kenosha, WI 53142-8213 | 2015-07-14 |
| 1194097311 | Emily Ann Lee | Physician Assistant | 10400 75th St Ste 215, Kenosha, WI 53142-7884 | 2012-02-03 |
| 1649506874 | Briana Elizabeth Aiken | Physician Assistant | 2801 14th Pl, Kenosha, WI 53140-4300 | 2009-10-22 |
| 1144317736 | Sarah N Stachon | Physician Assistant | 8959 34th Ave, Kenosha, WI 53142-5412 | 2006-10-06 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1154377091 | Keven R Mottinger | Physician Assistant | 3400 Market Ln, Kenosha, WI 53144-3430 | 2006-05-25 |
| 1164056727 | Michael James Church | Physician Assistant | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-02-23 |
| 1972133031 | Patricia Grzyb | Physician Assistant | 10400 75th St, Kenosha, WI 53142-7884 | 2020-01-16 |
| Find all providers in KENOSHA | ||||
Please comment or provide details below to improve the information on MRS. ALYSSA M RICCHIO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.