Individual provider Active NPI

Sydney Christine Schultz

  • Physician Assistant
  • Oak Creek, WI
National Provider Identifier
1417604976
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7003 S Howell Ave Ste 1600
Oak Creek, WI 53154-1460
Phone
(262) 476-4900
NPI assigned
Mar 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202K00000X 7031-23 WI
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7003 S Howell Ave Ste 1600
Oak Creek, WI 53154-1460

Mailing address

7003 S Howell Ave Ste 1600
Oak Creek, WI 53154-1460
Phone (262) 476-4900

Other practice location 1

400 N Executive Dr Ste 110
Brookfield, WI 53005-6029
Phone (262) 476-4900

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
I20221215003107 WI Practitioner - Physician Assistant 3971972860 Reassigns benefits to 2 organizations

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
Vanish, LLCGroup PAC ID 0345504684, 4 clinicians

Practice addresses (Care Compare)

12075 Corporate Pkwy
Suite 130
Mequon, WI 53092-2664
Phone (262) 476-4900

400 N Executive Dr
Suite 110
Brookfield, WI 53005-6029
Phone (262) 476-4900

7003 S Howell Ave
Suite 1600
Oak Creek, WI 53154-1460
Phone (262) 476-4900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7031-23WIMDPhlebology Physician

Interoperability endpoints

  • Direct secure messaging: sydney.schultz.1@24415.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1417604976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7003 S HOWELL AVE STE 1600",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531541460",
            "telephone_number": "262-476-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7003 S HOWELL AVE STE 1600",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531541460",
            "telephone_number": "262-476-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Executive Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530056029",
            "country_code": "US",
            "telephone_number": "262-476-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "SYDNEY",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-04",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": "WI",
            "license": "7031-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

Verify at the official NPI Registry.