Individual provider Active NPI

Amanda E Weber, APNP

  • Adult Health Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1093207094
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
8345 Issued in WI
Practice address
1751 E Main St
Waukesha, WI 53186-3940
Phone
(262) 547-0000
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 8345 WI Primary

Addresses

Primary practice location

1751 E Main St
Waukesha, WI 53186-3940

Mailing address

1751 E Main St
Waukesha, WI 53186-3940
Phone (262) 547-0000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181017001714 WI Practitioner - Nurse Practitioner 2466704564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Timothy G McAvoy MD SCGroup PAC ID 9739356999, 2 clinicians

Practice addresses (Care Compare)

1751 E Main St
Waukesha, WI 53186-3940
Phone (262) 547-0000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy G McAvoy MD SC CurrentSince Aug 18, 2018 Accepting new patients

Locations

1751 E Main St
Waukesha, WI 53186
Phone (262) 544-1755

1625 Coldwater Creek Dr
Waukesha, WI 53188
Phone (262) 521-8800

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

Organizations & group practices 1

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.

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1093207094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 E MAIN ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863940",
            "telephone_number": "262-547-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 E MAIN ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863940",
            "telephone_number": "262-547-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "AMANDA",
        "middle_name": "E",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "8345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.