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MARY J DERSE-HAYES P.A.
NPI 1679675557
Physician Assistant in Milwaukee, WI

Active since September 02, 2006PECOS EnrolledAccepts Medicare Assignment
2350 N LAKE DR, SUITE 302, MILWAUKEE, WI 53211(414) 298-7104(414) 298-7117 Get Directions Write a Review

NPPES record last updated: November 9, 2016. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mary J Derse-hayes P.a. NPPES

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

MARY J DERSE-HAYES P.A. (NPI 1679675557) is an individual physician assistant in Milwaukee, Wisconsin, licensed in Wisconsin (2046) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Froedtert Memorial Lutheran Hospital, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1679675557
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMARY J DERSE-HAYESCredential: P.A.
Location Address2350 N LAKE DR, SUITE 302Milwaukee, WI 53211-4528
Mailing Address788 N Jefferson St, Suite 300/attn. Kaaren ButzenMilwaukee, WI 53202-3718 · (414) 272-8950 · Fax (414) 225-2929
Phone(414) 298-7104
Fax(414) 298-7117
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateSeptember 2, 2006
Last NPPES UpdateNovember 9, 2016
✔ NPI 1679675557 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 · 2046
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.
2350 N LAKE DR, Milwaukee, WI 53211
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Other Identifiers 3

Medicaid1679675557WI
Medicare PIN0030001408WI
Medicare PIN736450050

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

Mary J Derse-hayes P.a. 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 ID3476550625
PECOS Enrollment IDI20061208000034
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 2

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.

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.
33 services33 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.
16 services16 patients

Hospital Affiliations CMS Care Compare

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

Froedtert Memorial Lutheran Hospital

Acute Care Hospitals · Milwaukee, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520177
Location9200 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53211 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.

IRINA KOSTOVA DIMITROVA M.D.
Obstetrics & Gynecology
2350 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 585-1949
COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE, INC
Clinic/Center (Multi-Specialty)
2350 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 585-1000
DR. LYLE GENE HENRY MD
Surgery
2350 N LAKE DR, SUITE 304
MILWAUKEE, WI 53211
Milwaukee County (414) 298-7220
KELLY A ISHERWOOD PA-C
Physician Assistant
2350 N LAKE DR, SUITE 206
MILWAUKEE, WI 53211
Milwaukee County (414) 298-7280
MICHAEL E KEEFE MD
Internal Medicine (Hematology & Oncology)
2350 N LAKE DR, SUITE 100
MILWAUKEE, WI 53211
Milwaukee County (414) 298-7250
MRS. AUDRA LYNN FELKER NP-C
Nurse Practitioner (Family)
2350 N LAKE DR, SUITE 400
MILWAUKEE, WI 53211
Milwaukee County (414) 271-1633
CATHERINE BARES APNP
Nurse Practitioner
2350 N LAKE DR, SUITE 100
MILWAUKEE, WI 53211
Milwaukee County (414) 298-7250
RACHEL TORGERSON KOEBEL PT, MPT, GCS
Physical Therapist
2350 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 296-2554

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 Mary Derse-hayes's NPI number?

The NPI number for Mary Derse-hayes is 1679675557. It was assigned to this individual provider in the NPPES registry on September 2, 2006.

Where is Mary Derse-hayes located?

Mary Derse-hayes practices at 2350 N Lake Dr Suite 302, Milwaukee, WI 53211. The listed phone number is (414) 298-7104.

What is Mary Derse-hayes's specialty?

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

Is Mary Derse-hayes enrolled in Medicare?

Yes. Mary Derse-hayes 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.

Is Mary Derse-hayes affiliated with any hospitals?

According to CMS data, Mary Derse-hayes is affiliated with Froedtert Memorial Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Mary Derse-hayes was last updated on November 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.