Individual provider Active NPI

Amanda Rae Doubleday, DO, MBA

  • Surgery Physician
  • Madison, WI
National Provider Identifier
1114212123
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
68958 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-1971
Phone
(608) 263-7502
Fax
(608) 263-7652
NPI assigned
Jun 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 68958 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-1971

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adoubleday855703@direct.uwhealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181026000076 WI Practitioner - General Surgery 8729342944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Kansas City University of Physicians and Surgeons, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Waukesha Surgical Specialists, S.C.Group PAC ID 6406843424, 18 clinicians

Practice addresses (Care Compare)

1111 Delafield St
Suite 209
Waukesha, WI 53188-3403
Phone (262) 542-0444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Master of Business Administration

State licenses

LicenseStateTypeSpecialty
68958WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waukesha Surgical Specialists, S.C. Surgery CurrentSince Jul 31, 2021 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Nov 5, 2018 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Nov 5, 2018 Accepting new patients
Regional General & Vascular Surgeons, S. C. Surgery Past Accepting new patients

Locations

195 Discovery Dr
Brookfield, WI 53045
Phone (262) 513-7100

507 S Monroe St
Lancaster, WI 53813
Phone (608) 723-2131

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

1185 Corporate Center Dr
Ste 200
Oconomowoc, WI 53066
Phone (262) 567-1499

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

1111 Delafield St
Ste 100
Waukesha, WI 53188
Phone (262) 928-4300

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

1111 Delafield St
Ste 209
Waukesha, WI 53188
Phone (414) 542-0444

Interoperability endpoints

  • Direct secure messaging: adoubleday855703@direct.uwhealth.org
  • Direct secure messaging: nmunjal1265752@direct.uwhealth.org
  • Direct secure messaging: adoubleday152368@direct.phci.org

Organizations & group practices 4

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 3

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": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1114212123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537921971",
            "telephone_number": "608-263-7502",
            "fax_number": "608-263-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUBLEDAY",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "DO, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "68958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adoubleday855703@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "600 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537921971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.