SONJA M ROSENTHAL PA-C
NPI 1750783684
Physician Assistant in Milwaukee, WI

NPI Status: Active since September 23, 2014

Contact Information

2801 W KINNICKINNIC RIVER PKWY STE 345
MILWAUKEE, WI
ZIP 53215
Phone: (414) 649-7900

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  • Individual
  • Female
  • Years of Experience 12
  • Physician Assistant
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SONJA ROSENTHAL

This page provides the complete NPI Profile along with additional information for Sonja Rosenthal, a primary care provider established in Milwaukee, Wisconsin with a medical specialization in Physician Assistant and more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1750783684 assigned on September 2014. The practitioner's primary taxonomy code is 363A00000X with license number 3339-23 (WI). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1750783684
Provider Name
SONJA M ROSENTHAL PA-C
Gender
Female
Entity Type
Individual
Location Address
2801 W KINNICKINNIC RIVER PKWY STE 345 MILWAUKEE, WI 53215
Location Phone
(414) 649-7900
Mailing Address
2801 W KINNICKINNIC RIVER PKWY STE 345 MILWAUKEE, WI 53215
Mailing Phone
(414) 649-7900
Medical School Name
OTHER
Graduation Year
2014
Is Sole Proprietor?
No
Enumeration Date
09-23-2014
Last Update Date
12-03-2021
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A primary care provider (PCP) like Sonja Rosenthal sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
3339-23
License State
WI
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • HMO Bronze $0 Medical Deductible - HMO
  • HMO Bronze 7500 - HMO
  • HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
  • HMO Gold 1500 - HMO
  • HMO Gold 2400 - HMO
  • HMO HDHP Bronze 7200 - HMO
  • HMO HDHP Silver 5400 - HMO
  • HMO Silver 5000 - HMO
  • HMO Silver 6600 - HMO
  • POS Bronze 7500 - POS
  • CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
  • CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
  • CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
  • CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
  • CGHC Bronze Standard $7500 - Envision Network - EPO
  • CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
  • CGHC Catastrophic $9200 - Envision Network - EPO
  • CGHC Gold $0 Ded - Envision Network - EPO
  • CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
  • CGHC Gold $3000 - Envision Network - EPO
  • Robin Oak $1,000 Gold - PPO
  • Robin Oak $1,500 Standard Gold - PPO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus (No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Value (Rx Copay, No Referrals) - HMO
  • UHC Bronze Value HSA (No Referrals) - HMO
  • UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage (No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
100040559MEDICAID (05)WI 

Medicare Participation & PECOS Enrollment Status

Sonja Rosenthal is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Sonja Rosenthal is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3375866189

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20150102000163

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 49 times for 37 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.73 for a new patient copayment and $16.84 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53215 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.92
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $20.73
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.37
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $16.84
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sonja Rosenthal is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
AURORA ST LUKES MEDICAL CENTER2900 W OKLAHOMA AVE
MILWAUKEE, WI 53215
(414) 649-6000Acute Care Hospitals
AURORA MEDICAL CENTER KENOSHA10400 75TH ST
KENOSHA, WI 53142
(262) 948-5600Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750783684
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271001486616
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 4 + 8 + 6 + 6 + 1 + 6 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1750783684 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1942745583 ERIC HAAS
Individual
Physician Assistant2801 W KINNICKINNIC RIVER PKWY STE 345
MILWAUKEE, WI 53215
(414) 828-0279
1164556684 MICHAEL FRANKLIN IOSSI MD
Individual
Orthopaedic Surgery (Foot and Ankle Surgery)2801 W KINNICKINNIC RIVER PKWY STE 345
MILWAUKEE, WI 53215
(414) 649-7900

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750783684, enumerated in the NPI registry as an "individual" on September 23, 2014

The provider is located at 2801 W Kinnickinnic River Pkwy Ste 345 Milwaukee, Wi 53215 and the phone number is (414) 649-7900

The provider's speciality is Physician Assistant with taxonomy code 363A00000X

The provider has more than 12 years of experience.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $67.37 and an average copayment of 16.84. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes.

The practitioner is affiliated to the following hospital(s): AURORA ST LUKES MEDICAL CENTER and AURORA MEDICAL CENTER KENOSHA. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on September 23, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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