NPIMap

Individual provider Active NPI

Daniel Thomas Line, P.A.-C

  • Medical Physician Assistant
  • Wausau, WI
National Provider Identifier
1649574898
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2704-023 Issued in WI
Practice address
333 Pine Ridge Blvd
Wausau, WI 54401-4120
Phone
(715) 847-2121
Fax
(715) 847-2078
NPI assigned
Jan 3, 2011
Last updated
Jan 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2704-023 WI Primary

Addresses

Primary practice location

333 Pine Ridge Blvd
Wausau, WI 54401-4120

Mailing address

333 Pine Ridge Blvd
Wausau, WI 54401-4120
Phone (715) 847-2121

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
I20110322000729 WI Practitioner - Physician Assistant 6507049970 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians
Gastrointestinal Associates S.C.Group PAC ID 4385677814, 42 clinicians

Practice addresses (Care Compare)

333 Pine Ridge Blvd
Wausau, WI 54401-4102

333 Pine Ridge Blvd
Wausau, WI 54401-4120
Phone (715) 847-2121

411 Westwood Dr
Wausau, WI 54401-4152
Phone (715) 847-2558

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.56 of 100Reported as group
Quality
87.43
Promoting interoperability
100
Improvement activities
40
Cost
78.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2704-023WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince Jan 17, 2011 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Jan 17, 2011 Accepting new patients
Gastrointestinal Associates S.C. CurrentSince Dec 30, 2025 Accepting new patients
The Howard Young Medical Center, Inc. CurrentSince Oct 1, 2022 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

411 Westwood Dr
Wausau, WI 54401
Phone (715) 479-0374

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Organizations & group practices 5

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 10

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": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1649574898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014120",
            "telephone_number": "715-847-2121",
            "fax_number": "715-847-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014120",
            "telephone_number": "715-847-2121",
            "fax_number": "715-847-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINE",
        "first_name": "DANIEL",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "2704-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.