NATHANIEL GARY KITZMANN NPI 1417544305

NPI Information

  • NPI: 1417544305
  • Provider Name: NATHANIEL GARY KITZMANN
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 20 S PARK ST STE 202
    MADISON, WI
    ZIP 53715
  • Phone: (608) 287-2090

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NPI Details

Nathaniel Gary Kitzmann is a medical physician assistant in Madison, WI with 5 years of experience. Nathaniel Gary Kitzmann NPI is 1417544305. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

20 S PARK ST STE 202
MADISON, WI
ZIP 53715-386
Phone: (608) 287-2090
Fax: (608) 287-2086

The NPI 1417544305 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/25/2020 and was last updated on 5/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantNo
2363AM0700XPhysician AssistantMedical5794-23WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11417544305MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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