ALYSA BLUM PA-C
NPI 1093140816
Physician Assistant in Waukesha, WI

Q: What is Alysa Blum's NPI number?

The NPI number for Alysa Blum is 1093140816. It was assigned to this individual provider in the NPPES registry on September 11, 2013. The provider is also known as Alysa Mcgovern Pa-C.

Q: What is Alysa Blum's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Alysa Blum was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 11, 2013

615 W MORELAND BLVD, WAUKESHA, WI 53188(262) 896-8420(262) 896-8521 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Alysa Blum Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALYSA BLUM PA-C (NPI 1093140816) is an individual physician assistant in Waukesha, Wisconsin, licensed in Wisconsin (3150-23) and active in the NPI registry since September 2013.

NPPES Registry Identity

NPI1093140816

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameALYSA BLUMCredential: PA-C

Location Address615 W MORELAND BLVDWaukesha, WI 53188-2462

Mailing Address615 W Moreland BlvdWaukesha, WI 53188-2462 · (262) 896-8429 · Fax (262) 896-8521

Phone(262) 896-8420

Fax(262) 896-8521

Sole ProprietorNo

Enumeration DateSeptember 11, 2013

Last NPPES UpdateMarch 7, 2023

✔ NPI 1093140816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 3150-23

Definition

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.

615 W MORELAND BLVD, Waukesha, WI 53188

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Other Names 1

Former Name (1)Alysa Mcgovern Pa-c

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARIANE MARGARET GRUDZINA RN

Registered Nurse (Community Health)