Individual provider Active NPI

Amanda Romens, PA-C

  • Physician Assistant
  • Columbus, WI
National Provider Identifier
1649804816
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5012-23 Issued in WI
Practice address
1515 Park Ave
Columbus, WI 53925-1618
Phone
(920) 623-2200
NPI assigned
Feb 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5012-23 WI
Physician Assistant 363A00000X 5012-23 WI Primary

Addresses

Primary practice location

1515 Park Ave
Columbus, WI 53925-1618

Mailing address

1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200

Other names 1

  • Amanda Wedderspoon Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MWEDDERSPOON354698@DIRECT-EHR-SSMHC.COM Direct SSM HEALTHCARE OF WI INC

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
I20200414000599 WI Practitioner - Physician Assistant 4082044128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Ridge Health IncGroup PAC ID 6800791484, shared by 3 NPIs, 70 clinicians

Practice addresses (Care Compare)

1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200

155 S Mallard Dr
Sun Prairie, WI 53590-8520
Phone (608) 834-4800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5012-23WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Ridge Health Inc. CurrentSince Apr 1, 2020 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Jan 17, 2026 Accepting new patients

Locations

118 W Maple Ave
Beaver Dam, WI 53916
Phone (920) 356-1000

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

1511 Park Ave
Columbus, WI 53925
Phone (920) 623-3012

155 S Mallard Dr
Sun Prairie, WI 53590
Phone (608) 834-4800

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a87187e5-fe2f-447e-bf32-4eeb3954a735/

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1649804816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251618",
            "telephone_number": "920-623-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251618",
            "telephone_number": "920-623-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMENS",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "5012-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5012-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MWEDDERSPOON354698@DIRECT-EHR-SSMHC.COM",
            "affiliation": "Y",
            "affiliationName": "SSM HEALTHCARE OF WI INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "MWEDDERSPOON354698@DIRECT-EHR-SSMHC.COM",
            "address_1": "1515 Park Ave",
            "city": "Columbus",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539251618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WEDDERSPOON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, WI

Sources for this page

Verify at the official NPI Registry.