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

Marystella Anidi

Individual provider Physician Assistant · NPI 1609509157

Marystella Anidi is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2023, 3 years ago. Practices as a sole proprietor and works from 7 locations. Licensed in Wisconsin.

Years since qualifying
3
Licensed in
WI
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

2906 S 20th St
Milwaukee, WI 53215-3732
Phone: (414) 672-1353
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (6)

  • 3946 Minnesota Ave Ne, Washington, DC 20019-2661 — (202) 913-7889
  • 1540 Provident Dr, Warsaw, IN 46580-3291 — (574) 372-5868
  • 1635 W National Ave, Milwaukee, WI 53204-1130 — (414) 672-1353
  • 1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 — (414) 672-1353
  • 4570 S 27th St, Milwaukee, WI 53221-2145 — (414) 672-1353
  • 309 E North St, Waukesha, WI 53188-3718 — (414) 672-1353

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8744-23 (WI)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 8744-23 (WI)

Record details

NPI number1609509157
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 1, 2022
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026
Mailing address1032 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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