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Active NPI 1285332072 Individual Practitioner Male Practitioner

Benjamin Randerson

Physician Assistant • Kenosha, WI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Benjamin Randerson is a certified Physician Assistant practicing in Kenosha, WI. With approximately 3 years of clinical experience since completing medical education in 2023, Benjamin Randerson delivers high-quality medical care to the local community at 10400 75TH ST.

Benjamin Randerson is affiliated with Aurora Medical Group, Inc. and accepts Medicare assignment.

Frequently performed procedures and clinical services include emergency department visit for life threatening or functioning severity, emergency department visit with moderate level of medical decision making, emergency department visit with low level of medical decision making. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

10400 75th St

Kenosha, WI 531427884

Telephone 2629485600
Associated Practice Facility / Clinic
🏢 Mea-Aea Kenosha Sc Facility NPI 1477546737

Medicare Profile & Education

Medical School

Other

Graduation Year

2023

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Kenosha, WI

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
3 Yrs -11.6 yrs vs City Avg
City Avg: 14.6 Yrs
State Avg: 14.1 Yrs
Regional Practice Density
45 Specialists

Practicing in Kenosha, WI (3517 Statewide)

Telehealth Adoption Rate
13.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
88.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Randerson (3 Years) 3 Yrs
Kenosha Specialty Average (14.6 Years) 14.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity
59 58 $1130.00 $135.65
99284 Emergency department visit with moderate level of medical decision making
46 46 $780.00 $91.63
99283 Emergency department visit with low level of medical decision making
28 27 $575.00 $55.06

Medical Specialties & State Licenses

CMS Verified: 2023-10-26
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WI 7503

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
100250637 (WI)

Hospital & Practice Group Affiliations

Aurora Medical Group, Inc.

252 Mchenry St, Burlington, WI 531051828

Phone: 2627677000

Aurora Medical Group, Inc.

1020 N 12th St, Milwaukee, WI 532331308

Phone: 4142193056

Aurora Medical Group, Inc.

248 Mchenry St, Burlington, WI 531051828

Phone: 2627678000

Aurora Medical Group, Inc.

13250 Washington Ave, Mount Pleasant, WI 531771516

Phone: 2628844000

Secondary Practice Locations

507 North 17th Street

Milwaukee, WI 53233

Phone: 4142885688

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Uzma Rezvi , MD

Anesthesiology

NPI 1003256850

Doctor of Medicine (M.D.)

Paula Osgood , CRNA

Nurse Anesthetist, Certified Registered

NPI 1043509268

Certified Registered Nurse Anesthetist

Dorothy Free

Nurse Anesthetist, Certified Registered

NPI 1053700682
Dana Madden

Physician Assistant

NPI 1073338596
Alison Ketterhagen , PA-C

Physician Assistant

NPI 1083036123

Physician Assistant (Certified)

NPI 1083660070

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location September 25, 2023

Registered at 10400 75TH ST, KENOSHA, WI 531427884 (Tel: 2629485600)

📍
Updated Business Mailing Address September 25, 2023

Registered at PO BOX 735044, CHICAGO, IL 606735044 (Tel: 2629485600)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 25, 2023

Physician Assistant (License #7503 in WI)

NPI Profile Active February 21, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location February 21, 2023

Registered at 507 NORTH 17TH STREET, MILWAUKEE, WI 53233 (Tel: 4142885688)

📍
Updated Business Mailing Address February 21, 2023

Registered at 507 NORTH 17TH STREET, MILWAUKEE, WI 53233

👤
Provider Name / Credentials Updated February 21, 2023

Recorded as BENJAMIN RANDERSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 21, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 21, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1285332072
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 21, 2023
Last Update: October 26, 2023
Sole Proprietor: Yes

Mailing Address

Po Box 735044

Chicago, IL 606735044

Phone: 2629485600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.