NPIMap

Individual provider Active NPI

Amir Bista

  • Hematology & Oncology Physician
  • Appleton, WI
National Provider Identifier
1427466655
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
67487 Issued in WI
Practice address
2500 E Capitol Dr
Appleton, WI 54911-8735
Phone
(920) 364-3600
NPI assigned
Jul 31, 2014
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT206839 PA
Hematology & Oncology Physician 207RH0003X 67487 WI Primary

Addresses

Primary practice location

2500 E Capitol Dr
Appleton, WI 54911-8735

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 364-3600

Other practice location 1

1 Guthrie Sq
Sayre, PA 18840-1625
Phone (570) 887-4559

Other practice location 2

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8000

Other identifiers 1

IdentifierTypeStateIssuer
100068956MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address abista266265@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803001896 WI Practitioner - Medical OncologyPractitioner - Internal Medicine 8628349701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

2500 E Capital Dr
Appleton, WI 54911-8735
Phone (920) 364-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT206839PAMDInternal Medicine Physician
67487WIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Dec 3, 2023 Accepting new patients
Thedacare Medical Center - New London, Inc. Past Accepting new patients
Thedacare Medical Center - Shawano, Inc. Past Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 738-4600

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: abista266265@direct.myadvocateaurora.org
  • Direct secure messaging: abista336411@direct.thedacare.org

Organizations & group practices 4

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1427466655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-364-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E CAPITOL DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118735",
            "telephone_number": "920-364-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Guthrie Sq",
            "address_purpose": "LOCATION",
            "city": "Sayre",
            "state": "PA",
            "postal_code": "188401625",
            "country_code": "US",
            "telephone_number": "570-887-4559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2845 Greenbrier Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116519",
            "country_code": "US",
            "telephone_number": "920-288-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISTA",
        "first_name": "AMIR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT206839",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "67487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100068956",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abista266265@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.