Dayken Elise Underdahl, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4110-23 Issued in WI

Practice address

717 W Moreland Blvd
Waukesha, WI 53188-2432

Phone

(262) 542-9100

NPI assigned

Jul 25, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440

  Family Medicine

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1043733637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 ARCADIAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865204",
            "telephone_number": "608-332-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882432",
            "telephone_number": "262-542-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERDAHL",
        "first_name": "DAYKEN",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "4110-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Tzougros, M.D.
• Matthew Lee Ubell, M.D.
• Amber R Ulickey
• Alyssa Ulmer, DPT
• Jason George Ulrichs, M.D.
• Up Connection Inc.
• Rachel Urban
• Megan Marie Urbinatti, M.S. CCC-SLP
• Urology Associates LTD SC
• Urology Institute of Waukesha SC

• Family Medicine Physician in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.