Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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Kelly Nicole Siverhus, PA-C, MS, RDN, CD

Individual provider Registered Dietitian · NPI 1972269876

Kelly Nicole Siverhus, PA-C, MS, RDN, CD is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2024, 2 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
2
Licensed in
WI
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
MS — Master of Science
A graduate science degree.
RDN — Registered Dietitian Nutritionist
The current title for a registered dietitian.

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Practice location Address checks out

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone: (414) 805-7782
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8121-23 (WI)
Registered Dietitian Taxonomy 133V00000X · Licence 3755-29 (WI)

Record details

NPI number1972269876
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , MS , RDN , CD
Sole proprietorNo
NPI enumeratedNovember 15, 2021
Last updated in NPPESDecember 13, 2024
Certification dateDecember 13, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 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

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at The Medical College of Wisconsin Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 2093 clinicians in the practice; 12 are shown here.

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