Individual provider Active NPI

Riann Sue Collar, PA-C

  • Physician Assistant
  • Appleton, WI
National Provider Identifier
1346807146
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1163445 Issued in WI
Practice address
1506 S Oneida St
Appleton, WI 54915-1305
Phone
(920) 738-2000
NPI assigned
May 28, 2019
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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 1163445 WI Primary

Addresses

Primary practice location

1506 S Oneida St
Appleton, WI 54915-1305

Mailing address

10001 W Innovation Dr Ste 200
Wauwatosa, WI 53226-4851
Phone (414) 771-6780

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
I20190829001093 WI Practitioner - Physician Assistant 8325376312 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13950 W Capitol Dr
Brookfield, WI 53005-2441
Phone (414) 302-5400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1163445WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Butte Des Morts Pathology, S.C. Current Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Physician Assistant CurrentSince Feb 1, 2023 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Nov 19, 2021 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Nov 19, 2021 Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 6

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 2

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1346807146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "414-771-6780",
            "fax_number": "414-238-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 S ONEIDA ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151305",
            "telephone_number": "920-738-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAR",
        "first_name": "RIANN",
        "middle_name": "SUE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1163445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.