Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Emily Thereas Hetzel, PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639787104

Emily Thereas Hetzel, PA is a Physician Assistant in Waukesha, Wisconsin. Qualified in 2020, 6 years ago. Practices with Prohealth Medical Group Inc, a 472-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

725 American Ave
Waukesha, WI 53188-5031
Phone: (262) 928-8800
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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 5243 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1639787104
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 21, 2020
Last updated in NPPESAugust 1, 2022
Certification dateAugust 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Prohealth Medical Group Inc — 472 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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