Blair M Rathjen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2611 Issued in WI

Practice address

710 Riverside Dr
Waupaca, WI 54981-1941

Phone

(715) 256-3000

Fax

(715) 256-3019

NPI assigned

Aug 2, 2010

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

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334
• Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brathjen3568@direct.thedacare.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.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment Care Compare group NPD
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  NPD (past)

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

• Thedacare Medical Center - Waupaca, Inc.

  • Critical Access Hospital
  • Waupaca, WI
  • NPI 1013995521
  Care Compare affiliation
• Thedacare Medical Center - Waupaca, Inc.

  • Critical Access Hospital
  • Waupaca, WI
  • NPI 1710333893
  Care Compare affiliation
• Thedacare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Neenah, WI
  • NPI 1023472842
  Care Compare affiliation
• Thedacare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Menasha, WI
  • NPI 1720434806
  Care Compare affiliation
• Thedacare Regional Medical Center-Neenah, Inc.

  • General Acute Care Hospital
  • Neenah, WI
  • NPI 1518993880
  Care Compare affiliation
• Thedacare Regional Medical Center-Neenah, Inc.

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1861943409
  Care Compare affiliation
• Thedcare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1679937494
  Care Compare affiliation

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1699089698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811941",
            "telephone_number": "715-256-3062",
            "fax_number": "715-256-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811941",
            "telephone_number": "715-256-3000",
            "fax_number": "715-256-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHJEN",
        "first_name": "BLAIR",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Purdy, D.O.
• Francis Rademacher, NP
• Rapha Counseling LLC
• Raschke Chiropractic Center SC
• Fred W Raschke, DC
• Charles Rathjen, MD
• Recover Health of Wisconsin, Inc.
• Stephanie Reents
• Aaron D. Reineking, PA
• Renew Physical Therapy and Wellness, LLC

• Physician Assistant in Waupaca, WI
• Providers in Waupaca, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.