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MS. GWEN JOYCE GETTELMAN PA-C
NPI 1427062835
Physician Assistant in Mequon, WI

Active since July 28, 2006PECOS EnrolledAccepts Medicare Assignment
83.31/100
CMS Quality Rating
10303 N PORT WASHINGTON RD, SUITE 101, MEQUON, WI 53092(262) 240-0440(262) 240-0441 Get Directions Write a Review

NPPES record last updated: February 9, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 9, 2023, Sep 16, 2021, Feb 17, 2021 (3 updates tracked since 2021).

About Ms. Gwen Joyce Gettelman Pa-c NPPES

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

MS. GWEN JOYCE GETTELMAN PA-C (NPI 1427062835) is an individual physician assistant in Mequon, Wisconsin, licensed in Wisconsin (1219-023) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1427062835
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. GWEN JOYCE GETTELMANCredential: PA-C
Location Address10303 N PORT WASHINGTON RD, SUITE 101Mequon, WI 53092-5760
Mailing Address801 York StManitowoc, WI 54220-4630 · (920) 663-9008 · Fax (920) 684-1439
Phone(262) 240-0440
Fax(262) 240-0441
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateJuly 28, 2006
Last NPPES UpdateFebruary 9, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2023
✔ NPI 1427062835 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 · 1219-023
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.
10303 N PORT WASHINGTON RD, Mequon, WI 53092
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Secondary Practice Locations 2

Location 17040 N Port Washington Rd Ste 404Glendale, WI 53217-3885 · Phone (414) 355-2405 · Fax (414) 355-6460
Location 22600 N Mayfair Rd Ste 810Milwaukee, WI 53226-1328 · Phone (414) 771-1122 · Fax (414) 771-1352

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) 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

Ms. Gwen Joyce Gettelman Pa-c 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 ID7719088731
PECOS Enrollment IDI20070720000538
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.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
344 services61 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
164 services122 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
160 services123 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
127 services93 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
82 services70 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
46 services42 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53092 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.38
Promoting Interoperability99
Improvement Activities40
Cost65.82

Reported Quality Measures

Biopsy Follow-Up
Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient by the performing physician
61%67 patients2/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%3,222 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%3,635 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%1,031 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
41%2,591 patients2/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
1%581 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
0%2,181 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
2%1,453 patients1/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 840 patients
Patients tobacco: 99% · 840 patients
98%85 patients5/55-star benchmark: 98%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
42%840 patients2/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%2,591 patients5/55-star benchmark: 100%
Psoriasis: Clinical Response to Oral Systemic or Biologic Medications
Percentage of psoriasis vulgaris patients receiving oral systemic or biologic therapy who meet minimal physician-or patient- reported disease activity levels.
67%27 patients
Psoriasis: Tuberculosis (TB) Prevention for Patients with Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis Patients on a Biological Immune Response Modifier
Percentage of patients whose providers are ensuring active tuberculosis prevention either through yearly negative standard tuberculosis screening tests or are reviewing the patient's history to determine if they have had appropriate management for a recent or…
91%23 patients
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%2,591 patients1/55-star benchmark: 79%
Tobacco Use and Help with Quitting Among Adolescents
The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user
96%269 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 8

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

DR. MICHAEL MAZIUS PHD
Psychologist (Clinical)
10303 N PORT WASHINGTON RD, #203
MEQUON, WI 53092
Ozaukee County (262) 241-5955
DR. ANTHONY BONFIGLIO MD
Dermatology
10303 N PORT WASHINGTON RD, SUITE 101
MEQUON, WI 53092
Ozaukee County (262) 240-0440
NINA SEBASTIAN BREDEHORN MSN, APNP, CPNP, PMH
Nurse Practitioner (Pediatrics)
10303 N PORT WASHINGTON RD, SUITE 203
MEQUON, WI 53092
Ozaukee County (262) 241-5955
MS. GABRIELLA C. BUCHNIK CCC-SLP
Speech-Language Pathologist
10303 N PORT WASHINGTON RD, SUITE 203
MEQUON, WI 53092
Ozaukee County (262) 241-5955
MRS. LORI A HEINRICH MD
Dermatology
10303 N PORT WASHINGTON RD, SUITE 101
MEQUON, WI 53092
Ozaukee County (262) 240-0440
DR. DON ANTHONY STOIBER DDS
Dentist
10303 N PORT WASHINGTON RD, SUITE #103A
MEQUON, WI 53092
Ozaukee County (262) 240-0405
TERRI PECKERMAN-STEIN MSW, LCSW
Social Worker (Clinical)
10303 N PORT WASHINGTON RD
MEQUON, WI 53092
Ozaukee County (262) 241-4955
NORTH SHORE DERMATOLOGY, S.C.
Dermatology
10303 N PORT WASHINGTON RD, SUITE 101
MEQUON, WI 53092
Ozaukee County (262) 240-0440

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gwen Gettelman's NPI number?

The NPI number for Gwen Gettelman is 1427062835. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Gwen Gettelman located?

Gwen Gettelman practices at 10303 N Port Washington Rd Suite 101, Mequon, WI 53092. The listed phone number is (262) 240-0440.

What is Gwen Gettelman's specialty?

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

Is Gwen Gettelman enrolled in Medicare?

Yes. Gwen Gettelman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Gwen Gettelman accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 2 other insurers list Gwen Gettelman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gwen Gettelman was last updated on February 9, 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.