Amanda M Reda-Goglio, APNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8874 Issued in WI

Practice address

199 County Road DF
Juneau, WI 53039

Phone

(920) 386-3492

NPI assigned

Nov 9, 2018

Last updated

Jul 31, 2020By the provider in NPPES

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Collaborative Solutions in Psychiatry, SCGroup PAC ID 6103131776, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Collaborative Solutions in Psychiatry, SC

  • Psychiatry Physician
  • Madison, WI
  • NPI 1619352226
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1063980845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 COUNTY ROAD DF",
            "city": "JUNEAU",
            "state": "WI",
            "postal_code": "530399512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COUNTY ROAD DF",
            "city": "JUNEAU",
            "state": "WI",
            "postal_code": "53039",
            "telephone_number": "920-386-3492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Hunters Trl",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "WI",
            "postal_code": "539013403",
            "country_code": "US",
            "telephone_number": "608-742-5518",
            "fax_number": "608-742-4087",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1343 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "WI",
            "postal_code": "539251614",
            "country_code": "US",
            "telephone_number": "920-623-5578",
            "fax_number": "920-623-9830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDA-GOGLIO",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "8874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Juneau, WI
• Providers in Juneau, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.