Andrea Yancey, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4757 Issued in WI

Practice address

11040 N State Road 77
Hayward, WI 54843-3606

Phone

(715) 934-4850

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Andrea Jacobs Former name

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Services, IncGroup PAC ID 9436061363, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tamarack Health Hayward Medical Center Hospital, Hayward, WI, CCN 521336

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medical Services, Inc

  dba Tamarack Health Hayward Medical Center

  • Critical Access Hospital
  • Hayward, WI
  • NPI 1912992827
  Medicare reassignment Care Compare group NPD
• Medical Services, Inc

  dba Clinic Services of Hayward Area Memorial Hospital

  • Rural Health Clinic/Center
  • Hayward, WI
  • NPI 1386316537
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

• Medical Services, Inc

  dba Tamarack Health Hayward Medical Center

  • Critical Access Hospital
  • Hayward, WI
  • NPI 1912992827
  Care Compare affiliation

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1497136428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11040 N STATE ROAD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433606",
            "telephone_number": "715-934-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11040 N STATE ROAD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433606",
            "telephone_number": "715-934-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANCEY",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2516",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2516",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "JACOBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamilyn D White, LPC, NCC
• Kay Marie Wilson, RDH
• Wesley Mark Wilson, LPC
• Janice Wilton, RDH
• Lester Yan, MD
• Melinda Young
• Randy A Young, CADCIII, NCAC II
• Sandra Zeznanski, RD CDE

• Physician Assistant in Hayward, WI
• Providers in Hayward, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.