Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NICOLE DUBISH PA
NPI 1275351462
Physician Assistant in Pleasant Prairie, WI

Q: What is Nicole Dubish's NPI number?

The NPI number for Nicole Dubish is 1275351462. It was assigned to this individual provider in the NPPES registry on September 27, 2024.

Q: What is Nicole Dubish'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 Nicole Dubish was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 58 days 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 27, 2024PECOS EnrolledAccepts Medicare Assignment

9555 76TH ST, PLEASANT PRAIRIE, WI 53158(262) 577-8000 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 10, 2026, Apr 20, 2026, Sep 27, 2024 (3 updates tracked since 2024).

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About Nicole Dubish Pa NPPES

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

NICOLE DUBISH PA (NPI 1275351462) is an individual physician assistant in Pleasant Prairie, Wisconsin, licensed in Illinois (085.012122) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1275351462

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameNICOLE DUBISHCredential: PA

Location Address9555 76TH STPleasant Prairie, WI 53158-1984

Mailing Address8897 Winding TrlSaint John, IN 46373-8778 · (219) 789-6150

Phone(262) 577-8000

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 27, 2024

Last NPPES UpdateJuly 10, 20263 updates tracked since enumeration

NPPES CertifiedJuly 10, 2026

✔ NPI 1275351462 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 IL · 085.012122

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.

9555 76TH ST, Pleasant Prairie, WI 53158

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Secondary Practice Location 1

Location 11 E Superior St Ste 306Chicago, IL 60611-2595 · Phone (312) 754-9404

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Dubish Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678008273

PECOS Enrollment IDI20241119003857

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53158 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

FROEDTERT SOUTH, INC.

General Acute Care Hospital