Individual provider Active NPI

Amanda Pascavis, PA-C

  • Physician Assistant
  • Wisconsin Rapids, WI
National Provider Identifier
1265188254
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2031 Peach St
Wisconsin Rapids, WI 54494-5181
Phone
(715) 423-0122
NPI assigned
Feb 28, 2022
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X WI Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2031 Peach St
Wisconsin Rapids, WI 54494-5181

Mailing address

507 North 17TH St
Milwaukee, WI 53233

Other practice location 1

507 North 17th ST
Milwaukee, WI 53233
Phone (414) 288-5688

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
I20230106002062 WI Practitioner - Physician Assistant 6406226422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Jan 30, 2023 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

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

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: apascavis194836@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 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": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1265188254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 NORTH 17TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 PEACH ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544945181",
            "telephone_number": "715-423-0122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "507 North 17th ST",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53233",
            "country_code": "US",
            "telephone_number": "414-288-5688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASCAVIS",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.