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

Mikaela J Koller

Individual provider Physician Assistant · NPI 1952156010

Mikaela J Koller is a Physician Assistant in Wauwatosa, Wisconsin. Qualified in 2025, 1 year ago. Registered with an NPI since 2024.

Years since qualifying
1
In the registry since
2024

Practice location Address checks out

10625 W North Ave Ste 101B
Wauwatosa, WI 53226-2315
Phone: (414) 877-5350
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1952156010
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 22, 2024
Last updated in NPPESAugust 15, 2025
Certification dateAugust 15, 2025

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)
Accepts Medicare assignment Not indicated

Other providers in Wauwatosa