MR. JUSTIN MATTHEW KITSON (NPI# 1821459710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821459710 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN MATTHEW KITSON |
| Credential | CAA |
| Practice Address |
225 S Executive Dr Brookfield WI 53005-4257 |
| Mailing Address |
5970 S Brandtwood Ct Cudahy WI 53110-3405 |
| Practice Telephone | 2627876758 |
| Mailing Telephone | 4029922997 |
| Enumeration Date | 2016-03-19 |
| Last Update Date | 2020-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367H00000X | Anesthesiologist Assistant | AA2020-002 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367H00000X | Anesthesiologist Assistant | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2211 Lomas Blvd Ne, Albuquerque, NM 871062719 | 5052722111 |
| Street Address |
225 S EXECUTIVE DR |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-4257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730177353 | Lowell H. Keppel | Family Medicine | 225 S Executive Dr, Brookfield, WI 53005-4266 | 2005-10-07 |
| 1790135457 | Dylan Bray | Anesthesiologist Assistant | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2016-06-14 |
| 1225410442 | Tia Covington | Anesthesiologist Assistant | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2015-06-24 |
| 1760647515 | St. Thomas Pain, LLC | Anesthesiology | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2008-07-22 |
| 1457512972 | William C. Rouman | Anesthesiology | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2008-06-18 |
| 1912189432 | Nevenka T Kevich | Anesthesiology | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2007-11-27 |
| 1447430665 | St. Thomas Pain Associates, LLC | Anesthesiology | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2007-11-05 |
| 1790964435 | Professional Pain Management, S.c. | Anesthesiology | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2007-10-30 |
| 1255423703 | Physicians Accounting, Ltd | Anesthesiology | 225 S Executive Dr, Brookfield, WI 53005-4266 | 2006-09-29 |
| 1578589156 | Linda S. Bluestein | Anesthesiology | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2006-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790135457 | Dylan Bray | Anesthesiologist Assistant | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2016-06-14 |
| 1225410442 | Tia Covington | Anesthesiologist Assistant | 225 S Executive Dr, Brookfield, WI 53005-4257 | 2015-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962054668 | Brandon Camel | Anesthesiologist Assistant | 619 N Segoe Rd, Madison, WI 53705-3112 | 2019-07-12 |
| 1407329428 | Kayla M Hickmann | Anesthesiologist Assistant | 5311 S Ridge Way Apt 204, Middleton, WI 53562-1244 | 2019-01-03 |
| 1730637976 | William Brett Organ | Anesthesiologist Assistant | 2915 E Wanda Ave, Cudahy, WI 53110-2536 | 2016-09-16 |
| 1134675358 | Kojo Bempong | Anesthesiologist Assistant | Ahcmg Anesthesiology, 4025 North 92nd Street, Wauwatosa, WI 53022 | 2016-08-28 |
| 1669857660 | Cayla Joanne Dittmer | Anesthesiologist Assistant | 818 N Star Dr Apt 119, Madison, WI 53718-3011 | 2015-07-21 |
| 1891761383 | William L Campbell | Anesthesiologist Assistant | 4830 Woodburn Dr, Madison, WI 53711-1346 | 2006-02-24 |
| 1366418840 | Jamie F Fridirici | Anesthesiologist Assistant | 9401 Whippoorwill Way, Middleton, WI 53562-5643 | 2006-02-24 |
| 1790392736 | Rachel Mcallister | Anesthesiologist Assistant | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-24 |
| 1831705664 | Fauzan Ali | Anesthesiologist Assistant | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2020-09-17 |
| 1942815063 | Riley S Bertram | Anesthesiologist Assistant | 202 South Park Street, 4 Tower, Madison, WI 53715 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
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| 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.