Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Nicole Siverhus, PA-C, MS, RDN, CD

Individual provider Registered Dietitian · NPI 1972269876

Kelly Nicole Siverhus, PA-C, MS, RDN, CD is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2024, 2 years ago. Practices with The Medical College of Wisconsin Inc, a 2,093-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
2
Licensed in
WI
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
MS — Master of Science
A graduate science degree.
RDN — Registered Dietitian Nutritionist
The current title for a registered dietitian.

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Practice location Address checks out

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone: (414) 805-7782
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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 8121-23 (WI)
Registered Dietitian Taxonomy 133V00000X · Licence 3755-29 (WI)

Record details

NPI number1972269876
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , MS , RDN , CD
Sole proprietorNo
NPI enumeratedNovember 15, 2021
Last updated in NPPESDecember 13, 2024
Certification dateDecember 13, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice The Medical College Of Wisconsin Inc — 2093 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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