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

Michelle Olga Mironovich

Individual provider Physician Assistant · NPI 1881441962

Michelle Olga Mironovich is a Physician Assistant in Green Bay, Wisconsin. Qualified in 2025, 1 year ago. Practices with Baycare Clinic LLP, a 196-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
1
Licensed in
WI
In the registry since
2024
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Practice location Address checks out

1110 Kepler Dr
Green Bay, WI 54311-8306
Phone: (920) 288-5555
Fax: (920) 288-5550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2502 S Ashland Ave, Green Bay, WI 54304-5252 — (651) 635-8000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8641 (WI)

Record details

NPI number1881441962
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 6, 2024
Last updated in NPPESMay 7, 2026
Certification dateMay 7, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Baycare Clinic Llp — 196 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Green Bay