MATTHEW ALLAN MICKELSON
NPI 1942907647
Nurse Practitioner - Family in Deforest, WI

Q: What is Matthew Mickelson's NPI number?

The NPI number for Matthew Mickelson is 1942907647. It was assigned to this individual provider in the NPPES registry on February 13, 2023.

Q: What is Matthew Mickelson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Mickelson was last updated on September 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 February 13, 2023PECOS EnrolledAccepts Medicare Assignment

4200 SAVANNAH DR, DEFOREST, WI 53532(608) 417-3300 Get Directions Write a Review

NPPES record last updated: September 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 5, 2023, Feb 28, 2023, Feb 22, 2023 and 1 more (4 updates tracked since 2023).

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About Matthew Allan Mickelson NPPES

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

MATTHEW ALLAN MICKELSON (NPI 1942907647) is an individual family provider in Deforest, Wisconsin, licensed in Wisconsin (13661-33) and active in the NPI registry since February 2023. He is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1942907647

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMATTHEW ALLAN MICKELSON

Location Address4200 SAVANNAH DRDeforest, WI 53532-2909

Mailing Address202 S Park StMadison, WI 53715-1507 · (608) 417-6000

Phone(608) 417-3300

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateFebruary 13, 2023

Last NPPES UpdateSeptember 12, 20234 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2023

✔ NPI 1942907647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in WI · 13661-33

Also ListedRegistered NurseTaxonomy 163W00000X · License 241314 (WI)

4200 SAVANNAH DR, Deforest, WI 53532

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners 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

Matthew Allan Mickelson 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 ID2668838087

PECOS Enrollment IDI20230510000083

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

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.

62 services57 patients

Hospital Affiliations CMS Care Compare

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

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520008

Location725 American AveWaukesha, WI 53188 · Waukesha County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53532 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

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

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 13

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

MON L YEE MD

Family Medicine