Individual provider Active NPI

Isabelle Anne Florence Amigues, MD

  • Rheumatology Physician
  • Green Bay, WI
National Provider Identifier
1588950018
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
58173 Issued in CO
Practice address
3263 Eaton Rd
Green Bay, WI 54311-6830
Phone
(920) 433-6700
Fax
(920) 433-6719
NPI assigned
Jun 23, 2011
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 81030-20 WI
Rheumatology Physician 207RR0500X 75082 MN
Rheumatology Physician 207RR0500X 4301508255 MI
Rheumatology Physician 207RR0500X 58173 CO Primary

Addresses

Primary practice location

3263 Eaton Rd
Green Bay, WI 54311-6830

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other practice location 1

16 Lakeside Ln
Denver, CO 80212-7413
Phone (303) 813-1090

Other practice location 2

411 Stageline Rd Ste 150
Hudson, WI 54016-7848
Phone (715) 531-6700

Other identifiers 2

IdentifierTypeStateIssuer
100211515MedicaidWI
1588950018MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170818000588 CO Practitioner - Rheumatology 7012202559

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58173COMDRheumatology Physician
75082MNMDRheumatology Physician
81030-20WIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Sep 18, 2023 Accepting new patients
Group Health, Inc. CurrentSince Sep 18, 2023 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

411 Stageline Rd
Ste 150
Hudson, WI 54016
Phone (715) 531-6700

744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251

Organizations & group practices 3

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1588950018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3263 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116830",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Lakeside Ln",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802127413",
            "country_code": "US",
            "telephone_number": "303-813-1090",
            "fax_number": "414-626-6403",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 Stageline Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540167848",
            "country_code": "US",
            "telephone_number": "715-531-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIGUES",
        "first_name": "ISABELLE",
        "middle_name": "ANNE FLORENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "81030-20",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MN",
            "license": "75082",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301508255",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CO",
            "license": "58173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100211515",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588950018",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.