Individual provider Active NPI

Hannah Elizabeth Wenzlick, PA-C

  • Physician Assistant
  • Antigo, WI
National Provider Identifier
1366908790
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4609 Issued in WI
Practice address
112 E 5TH Ave
Antigo, WI 54409-2710
Phone
(715) 623-2351
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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 4609 WI Primary

Addresses

Primary practice location

112 E 5TH Ave
Antigo, WI 54409-2710

Mailing address

112 E 5TH Ave
Antigo, WI 54409-2710
Phone (715) 623-2351

Other practice location 1

112 E 5th Ave
Antigo, WI 54409-2710
Phone (715) 623-2331

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
I20190409001654 WI Practitioner - Physician Assistant 4789925306 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital Inc CurrentSince Oct 1, 2020 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Human Services Board Serving North Central Health Care Facility CurrentSince Jan 26, 2022 Accepting new patients
Human Services Board Serving North Central Heatlh Care Facility CurrentSince Jan 26, 2022 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Oct 1, 2020 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

110 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2351

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

2400 Marshall St
Ste A
Wausau, WI 54403
Phone (715) 848-4600

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

1100 Lake View Dr
Wausau, WI 54403
Phone (715) 848-4454

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10114/brand/2/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1366908790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 E 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Antigo",
            "state": "WI",
            "postal_code": "544092710",
            "country_code": "US",
            "telephone_number": "715-623-2331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENZLICK",
        "first_name": "HANNAH",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antigo, WI

Sources for this page

Verify at the official NPI Registry.