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

Maria A Park, PA

Individual provider Physician Assistant · NPI 1104263979

Maria A Park, PA is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2013, 13 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
13
Licensed in
WI
In the registry since
2013
Specialties on file
3
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

9200 W Wisconsin Avenue Colorectal Surgery
Milwaukee, WI 53226-3522
Phone: (414) 955-5783
Fax: (414) 955-0087
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 3119-23 (WI)
Physician Assistant Taxonomy 363A00000X · Licence 3119-23 (WI)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 3119-23 (WI)

Record details

NPI number1104263979
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 3, 2013
Last updated in NPPESJanuary 8, 2024
Certification dateJanuary 5, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 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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