NPIMap

Individual provider Active NPI

Pamela Falcon

  • Family Medicine Physician
  • Green Bay, WI
National Provider Identifier
1124680764
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
74296-20 Issued in WI
Practice address
102 N Washington St
Green Bay, WI 54301-4209
Phone
(920) 496-4700
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 74296-20 WI Primary

Addresses

Primary practice location

102 N Washington St
Green Bay, WI 54301-4209

Mailing address

102 N Washington St
Green Bay, WI 54301-4209
Phone (920) 496-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pfalcon249475@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220818001487 WI Practitioner - Family Practice 7618202680 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

102 N Washington St
Green Bay, WI 54301-4209
Phone (920) 496-4700

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
  • St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74296-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Family Medicine Current Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Aug 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

102 N Washington St
Green Bay, WI 54301

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: pfalcon249475@ewd.direct.hshs.org

Organizations & group practices 8

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 6

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": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1124680764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N WASHINGTON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014209",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N WASHINGTON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014209",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCON",
        "first_name": "PAMELA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "74296-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfalcon249475@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "102 N Washington St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543014209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.