Alyssa S Deppong, PHYSICIANASSISTANT
Alyssa S Deppong, PHYSICIANASSISTANT is a Physician Assistant in Pleasant Prairie, Wisconsin. Qualified in 2019, 7 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group and accepts Medicare assignment. Licensed in Wisconsin.
- Years since qualifying
- 7
- Licensed in
- WI
- In the registry since
- 2019
- Specialties on file
- 2
Practice location Address checks out
12500 Aurora DrPleasant Prairie, WI 53158-1227
Phone: (262) 857-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 4736-23 (WI) |
|---|---|
| Gastroenterology Physician | Taxonomy 207RG0100X · Licence 4736-23 (WI) |
Record details
| NPI number | 1538721451 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PHYSICIANASSISTANT |
| Sole proprietor | No |
| NPI enumerated | July 1, 2019 |
| Last updated in NPPES | December 5, 2022 |
| Certification date | December 5, 2022 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2019 (7 years in practice) |
| Group practice | Aurora Medical Group, Inc. — 3741 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |