Individual provider Active NPI

Amy M. Koelling, PA

  • Physician Assistant
  • Minocqua, WI
National Provider Identifier
1518065622
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
915 Issued in WI
Practice address
9576 Highway 70
Minocqua, WI 54548-9067
Phone
(715) 387-5511
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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 915 WI Primary

Addresses

Primary practice location

9576 Highway 70
Minocqua, WI 54548-9067

Mailing address

9576 Highway 70
Minocqua, WI 54548-9067
Phone (715) 387-5511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

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
I20101022001285 WI Practitioner - Physician Assistant 1254524101 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

2727 Plaza Dr
Marshfield, WI 54449-5703

9576 Hwy 70
Minocqua, WI 54548-9067
Phone (715) 358-1710

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
915WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Apr 23, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 16, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 16, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince Sep 24, 1996 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Apr 23, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Mar 16, 2022 Accepting new patients
Memorial Hospital Inc CurrentSince Apr 23, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Mar 16, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Apr 23, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Apr 23, 2023 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

9576 State Highway 70
Minocqua, WI 54548
Phone (715) 358-1000

9601 Townline Rd
Minocqua, WI 54548
Phone (715) 358-1000

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

720 E King Rd
#A
Tomahawk, WI 54487
Phone (715) 453-2164

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: amy.koelling@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1518065622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9576 HIGHWAY 70",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489067",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9576 HIGHWAY 70",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489067",
            "telephone_number": "715-387-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELLING",
        "first_name": "AMY",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9576 Highway 70",
            "city": "Minocqua",
            "state": "WI",
            "country_code": "US",
            "postal_code": "545489067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minocqua, WI

Sources for this page

Verify at the official NPI Registry.