Individual provider Active NPI

Florence Tavera Neilitz, PA-C

  • Physician Assistant
  • Wisconsin Rapids, WI
National Provider Identifier
1215480421
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3764-23 Issued in WI
Practice address
410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone
(715) 421-7474
Fax
(715) 422-7752
NPI assigned
Jul 25, 2016
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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 3764-23 WI Primary

Addresses

Primary practice location

410 Dewey St
Wisconsin Rapids, WI 54494-4715

Mailing address

410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone (715) 421-7474

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
I20160829001754 WI Practitioner - Physician Assistant 7517252695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2031 Peach St
Wisconsin Rapids, WI 54494-5181
Phone (715) 423-0122

410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone (715) 423-6060

420 Dewey St
Wisconsin Rapids, WI 54494-4714
Phone (715) 422-7750

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Quality
87.9
Promoting interoperability
100
Improvement activities
40
Cost
73.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3764-23WIMDPhysician Assistant
3764WIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Interoperability endpoints

  • Direct secure messaging: fneilitz117474@direct.aspirus.org
  • FHIR API: https://api.platform.athenahealth.com/10114/brand/2/csg/1/fhir/r4

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 4

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": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1215480421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944715",
            "telephone_number": "715-421-7474",
            "fax_number": "715-422-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944715",
            "telephone_number": "715-421-7474",
            "fax_number": "715-422-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILITZ",
        "first_name": "FLORENCE",
        "middle_name": "TAVERA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3764-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.