Individual provider Active NPI

Heather Kimbrough McDonald Wetzel, PA-C

  • Physician Assistant
  • Oshkosh, WI
National Provider Identifier
1538815402
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
515 S Washburn St Ste 204
Oshkosh, WI 54904-7996
Phone
(920) 232-1130
NPI assigned
Mar 1, 2022
Last updated
Jul 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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 Primary

Addresses

Primary practice location

515 S Washburn St Ste 204
Oshkosh, WI 54904-7996

Mailing address

515 S Washburn St Ste 204
Oshkosh, WI 54904-7996
Phone (920) 232-1130

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
I20230103002876 WI Practitioner - Physician Assistant 7113397357 Reassigns benefits to 1 organization

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
Fox Valley Dermatology SCGroup PAC ID 4284657461, 2 clinicians

Practice addresses (Care Compare)

515 S Washburn St
Suite 204
Oshkosh, WI 54904-7996
Phone (920) 232-1130

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: hemcdonald@foxvalleydermatology.emadirect.md

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1538815402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S WASHBURN ST STE 204",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047996",
            "telephone_number": "920-232-1130",
            "fax_number": "920-232-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S WASHBURN ST STE 204",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047996",
            "telephone_number": "920-232-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "HEATHER",
        "middle_name": "KIMBROUGH MCDONALD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.