Amanda M Reda-Goglio, APNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Juneau, WI
NPI 1063980845 · NPPES record last updated Jul 31, 2020
Key facts
- NPI
- 1063980845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 8874 (WI)
- Practice address
- 199 County Road DF
Juneau, WI 53039 - Phone
- (920) 386-3492
- NPI assigned
- Nov 9, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Collaborative Solutions in Psychiatry, SC
Practice addresses (Care Compare)
6515 Grand Teton PLZ
Suite 220
Madison, WI 53719-1048
7818 Big Sky Dr
Madison, WI 53719-2840
Phone (608) 713-9898
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 |
|---|---|---|---|---|
| I20181214000222 | WI | Practitioner - Nurse Practitioner | 8022353325 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collaborative Solutions in Psychiatry, SC | Current |
Accepting new patients |
Locations
7818 Big Sky Dr
Ste 103
Madison, WI 53719
Phone (608) 203-6267
6515 Grand Teton Plz
Ste 220
Madison, WI 53719
Phone (608) 713-9898
5100 Eastpark Blvd
Madison, WI 53718
Phone (608) 222-8232
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 8874 | WI | Yes |
Addresses
Primary practice location
199 County Road DF
Juneau, WI 53039
Mailing address
199 County Road DF
Juneau, WI 53039-9512
Other practice location 1
2901 Hunters Trl
Portage, WI 53901-3403
Phone (608) 742-5518
Other practice location 2
1343 Park Ave
Columbus, WI 53925-1614
Phone (920) 623-5578
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063980845 | Medicaid | WI | |
| 8874 | Other | WI | ADVANCED PRACTICE NURSE PRESCRIBER |
Other providers in Juneau, WI
- Stephen R Packee
- Rosey Phoenix
- Josie Plaisance
- Clara Pulvermacher
- Lindsay Radloff
- Jill Marie Reifsnider
- Kerri Jean Ritsche
- Rock River Foot & Ankle Clinic, SC
- Christopher Roorda
- Kayla Anne Ruff
All providers in Juneau, WI · Psychiatric/Mental Health 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 Jul 31, 2020. 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.