Individual provider Active NPI

Colin Van Pay, PA-C

  • Physician Assistant
  • Marinette, WI
National Provider Identifier
1083266548
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4796-23 Issued in WI
Practice address
3003 University Dr
Marinette, WI 54143-4110
Phone
(715) 735-4200
NPI assigned
Jul 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4796-23 WI Primary

Addresses

Primary practice location

3003 University Dr
Marinette, WI 54143-4110

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 389-2338

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cvanpay235703@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20220302002404 MI Practitioner - Physician Assistant 5496081747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

3901 Beaubien 1St Floor
Detroit, MI 48201-2119
Phone (313) 745-5227

3901 Beaubien St
Detroit, MI 48201-2119

6071 W Outer Dr
Detroit, MI 48235-2624

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4796WIMDMental Health Counselor
4796-23WIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: cvanpay235703@direct.myadvocateaurora.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1083266548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-389-2338",
            "fax_number": "414-385-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 UNIVERSITY DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434110",
            "telephone_number": "715-735-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN PAY",
        "first_name": "COLIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4796-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cvanpay235703@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3003 University Dr",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541434110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3003 University Dr",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541434110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.