NPIMap

Individual provider Active NPI

Kaley M Mayer, PA-C

  • Physician Assistant
  • Neenah, WI
National Provider Identifier
1225665797
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5123 Issued in WI
Practice address
200 Theda Clark Medical PLZ
Neenah, WI 54956-2721
Phone
(920) 358-1223
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 5123 WI Primary

Addresses

Primary practice location

200 Theda Clark Medical PLZ
Neenah, WI 54956-2721

Mailing address

5017 N Cherryvale Ave
Appleton, WI 54913-9385
Phone (608) 395-4083

Other practice location 1

5017 N Cherryvale Ave
Appleton, WI 54913-9385
Phone (608) 395-4083

Other names 1

  • Kaley M Heiman Former name

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
I20200824000324 WI Practitioner - Physician Assistant 8426474305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1080 W Fond Du Lac St
Ripon, WI 54971-9286

130 2ND St
Neenah, WI 54956-2883
Phone (920) 725-0077

2500 E Capital Dr
Appleton, WI 54911-8735

3 Neenah Ctr
Neenah, WI 54956-3070

333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 720-2300

400 S Maple St
Black Creek, WI 54106-9787
Phone (920) 984-3361

4480 W Spencer St
Appleton, WI 54915
Phone (920) 738-4800

600 N Westhaven Dr
Oshkosh, WI 54904-6926
Phone (920) 725-0077

N2934 State Rd
22 FL 1
Wautoma, WI 54982-5267
Phone (920) 361-6330

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Jun 10, 2023 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients
Thedacare Medical Center - Shawano, Inc. Past Accepting new patients

Locations

2500 E Capitol Dr
Ste 1600
Appleton, WI 54911

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

200 Theda Clark Medical Plz
Neenah, WI 54956
Phone (920) 358-1223

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

200 Theda Clark Medical Plz
Ste 310
Neenah, WI 54956
Phone (920) 358-1223

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

250 W 6th Ave
Oshkosh, WI 54902
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: kmayer332006@direct.thedacare.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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1225665797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 N CHERRYVALE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139385",
            "telephone_number": "608-395-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 THEDA CLARK MEDICAL PLZ",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562721",
            "telephone_number": "920-358-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5017 N Cherryvale Ave",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549139385",
            "country_code": "US",
            "telephone_number": "608-395-4083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYER",
        "first_name": "KALEY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALEY",
            "last_name": "HEIMAN",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.