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

Sonya Marie Videkovich, PA-C, MPAS

Individual provider Physician Assistant · NPI 1336664143

Sonya Marie Videkovich, PA-C, MPAS is a Physician Assistant in St Francis, Wisconsin. Qualified in 2017, 9 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
9
Licensed in
WI
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

2000 E Layton Ave
St Francis, WI 53235-6053
Phone: (414) 744-7880
Show map & directions

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

Additional practice locations (1)

  • 430 E Division St, Fond Du Lac, WI 54935-4560 — (920) 929-2300

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4138 (WI)

Record details

NPI number1336664143
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , MPAS
Sole proprietorNo
NPI enumeratedAugust 14, 2017
Last updated in NPPESOctober 17, 2023
Certification dateOctober 17, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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