Amber L Wagner, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3165-23 Issued in WI

Practice address

1260 Sentry Dr Ste 140
Waukesha, WI 53186-5990

Phone

(262) 524-1024

Fax

(262) 524-8767

NPI assigned

Jul 16, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Amber L Wisniewski Former name

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Associates SCGroup PAC ID 7416841663, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116
• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
• Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071
• Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awagner47143@direct.phci.org

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.

• Nephrology Associates SC

  • Specialist
  • Fort Atkinson, WI
  • NPI 1326222423
  Medicare reassignment Care Compare group
• Nephrology Associates SC

  • Specialist
  • Waukesha, WI
  • NPI 1871679514
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361

  Hospital

  Care Compare affiliation
• Fort Healthcare, Inc.

  • General Acute Care Hospital
  • Fort Atkinson, WI
  • NPI 1811916281
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Oconomowoc, WI
  • NPI 1366420531
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  • Community/Retail Pharmacy
  • Oconomowoc, WI
  • NPI 1497942205

  Hospital

  Care Compare affiliation
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation
• Watertown Medical Center LLC

  • General Acute Care Hospital
  • Watertown, WI
  • NPI 1992776041
  Care Compare affiliation

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1679914840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 SENTRY DR STE 140",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865990",
            "telephone_number": "262-524-1024",
            "fax_number": "262-524-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 SENTRY DR STE 140",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865990",
            "telephone_number": "262-524-1024",
            "fax_number": "262-524-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AMBER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "3165-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "WISNIEWSKI",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Vylonis, D.O.
• Desiree Wachtendonk
• Wade Family Dental
• Donald Wade, D.D.S.
• Thomas John Wade, M.D.
• Kayla Rose Wagner, PA-C
• Geneva M Wahl, M.D.
• Katherine Wahlgren
• Christine Wahmhoff, M.D.
• Joanne Waite, MS/CCC-SLP

• Medical Physician Assistant in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.