MS. TISHA M KENNEBECK PA-C
NPI 1710094248
Physician Assistant in Oshkosh, WI

Active since August 23, 2006PECOS EnrolledAccepts Medicare Assignment
414 DOCTORS CT, OSHKOSH, WI 54901(920) 303-8700(920) 303-5004 Get Directions Write a Review

NPPES record last updated: November 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 11, 2025, Mar 7, 2023, Nov 26, 2021 (3 updates tracked since 2021).

About Ms. Tisha M Kennebeck Pa-c NPPES

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

MS. TISHA M KENNEBECK PA-C (NPI 1710094248) is an individual physician assistant in Oshkosh, Wisconsin, licensed in Wisconsin (1085-023) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Oshkosh, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1710094248
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. TISHA M KENNEBECKCredential: PA-C
Location Address414 DOCTORS CTOshkosh, WI 54901
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250
Fax(920) 303-5004
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateAugust 23, 2006
Last NPPES UpdateNovember 11, 20253 updates tracked since enumeration
NPPES CertifiedNovember 11, 2025
NPI 1710094248 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 · 1085-023
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.

414 DOCTORS CT, Oshkosh, WI 54901

Other Identifiers 1

Medicaid42975400WI

Accepted 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. Tisha M Kennebeck 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 ID6800795857
PECOS Enrollment IDI20040308000194
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 6

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 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.
98 services70 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
37 services37 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.
22 services20 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
21 services21 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
17 services17 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
16 services16 patients

Hospital Affiliations CMS Care Compare

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

Aurora Medical Ctr Oshkosh

Acute Care Hospitals · Oshkosh, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520198
Location855 N Westhaven DriveOshkosh, WI 54904 · Winnebago County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54901 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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
3 suppliers11 claims21 services$4.71 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Nurse Practitioner
414 DOCTORS CT
OSHKOSH, WI 54901
Family Medicine
414 DOCTORS CT
OSHKOSH, WI 54901
Psychologist (Clinical)
414 DOCTORS CT
OSHKOSH, WI 54901
Pharmacy
414 DOCTORS CT, SUITE 100
OSHKOSH, WI 54901
Obstetrics & Gynecology
414 DOCTORS CT
OSHKOSH, WI 54901
Family Medicine
414 DOCTORS CT
OSHKOSH, WI 54901
Durable Medical Equipment & Medical Supplies
414 DOCTORS CT
OSHKOSH, WI 54901
Social Worker (Clinical)
414 DOCTORS CT
OSHKOSH, WI 54901

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 Tisha Kennebeck's NPI number?

The NPI number for Tisha Kennebeck is 1710094248. It was assigned to this individual provider in the NPPES registry on August 23, 2006.

Where is Tisha Kennebeck located?

Tisha Kennebeck practices at 414 Doctors Ct, Oshkosh, WI 54901. The listed phone number is (920) 303-8700.

What is Tisha Kennebeck's specialty?

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

Is Tisha Kennebeck enrolled in Medicare?

Yes. Tisha Kennebeck 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 Tisha Kennebeck accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners, Quartz and UnitedHealthcare list Tisha Kennebeck 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.

Is Tisha Kennebeck affiliated with any hospitals?

According to CMS data, Tisha Kennebeck is affiliated with Aurora Medical Ctr Oshkosh.

When was this NPI record last updated?

The NPPES record for Tisha Kennebeck was last updated on November 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.