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

Kelly M Glodowski, PA

Individual provider Physician Assistant · NPI 1184993768

Kelly M Glodowski, PA is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2011, 15 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
15
Licensed in
WI
In the registry since
2011
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

2901 W Kinnickinnic River Pkwy Ste 101
Milwaukee, WI 53215
Phone: (414) 649-7710
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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 2756 (WI)

Record details

NPI number1184993768
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 28, 2011
Last updated in NPPESJanuary 29, 2024
Certification dateJanuary 29, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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