Individual provider Active NPI

Julie Amtmann, PA

  • Physician Assistant
  • Oconomowoc, WI
National Provider Identifier
1366694077
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
937 Issued in WI
Practice address
915 Summit Ave
Oconomowoc, WI 53066-3921
Phone
(262) 569-2300
NPI assigned
Oct 14, 2008
Last updated
Oct 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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 937 WI Primary

Addresses

Primary practice location

915 Summit Ave
Oconomowoc, WI 53066-3921

Mailing address

915 Summit Ave
Oconomowoc, WI 53066-3921
Phone (262) 569-2300

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
I20040313000199 WI Practitioner - Physician Assistant 8022907443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1500 Walnut Ridge Dr
Hartland, WI 53029-9317
Phone (262) 928-7500

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Oct 19, 2018 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

195 Discovery Dr
Brookfield, WI 53045
Phone (262) 513-7100

2750 Golf Rd
Delafield, WI 53018
Phone (262) 928-4900

1500 Walnut Ridge Dr
Hartland, WI 53029
Phone (262) 513-7500

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

13900 W National Ave
New Berlin, WI 53151
Phone (262) 928-4500

1185 Corporate Center Dr
Ste 155
Oconomowoc, WI 53066
Phone (262) 567-3528

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

1011 Spring City Dr
Waukesha, WI 53186
Phone (262) 925-0370

2130 Big Bend Rd
Waukesha, WI 53189
Phone (262) 513-7555

717 W Moreland Blvd
Waukesha, WI 53188
Phone (262) 542-9100

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Organizations & group practices 3

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": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1366694077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663921",
            "telephone_number": "262-569-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663921",
            "telephone_number": "262-569-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMTMANN",
        "first_name": "JULIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.