Amanda Marie Abaya, APNP
Individual provider Active NPI Family Nurse Practitioner · Appleton, WI
NPI 1053145193 · NPPES record last updated Aug 30, 2024
Key facts
- NPI
- 1053145193
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 15720 (WI)
- Practice address
- W5402 Mile Long Dr
Appleton, WI 54915-5225 - Phone
- (920) 204-2080
- NPI assigned
- Aug 30, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Apogee Medical Group Wisconsin SC
Practice addresses (Care Compare)
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-3500
Hospital & facility affiliations
- Bellin Memorial Hospital
- Bellin Health Oconto Hospital
- Osf St Francis Hospital and Medical Group
- Door County Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250515001166 | WI | Practitioner - Nurse Practitioner | 2163940933 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15720 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Medical Group, Wisconsin, S.C | Current |
Accepting new patients |
Locations
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 15720 | WI | Yes |
Addresses
Primary practice location
W5402 Mile Long Dr
Appleton, WI 54915-5225
Mailing address
W5402 Mile Long Dr
Appleton, WI 54915-5225
Phone (920) 204-2080
Other names
- Amanda Marie Tomajcik
Other providers in Appleton, WI
- Aascend Chiropractic Institute, S.C.
- Aascend Pain Institute, SC
- Benjamin Thomas Abadeer
- Kimberly N Abalan
- Katie Abata
- Ashraf Abbas
- Abbie Goodman, LLC
- Abbott Family Chiropractic, S.C.
- Gregory Abbott
- Miranda Abbott
All providers in Appleton, WI · Family Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.