NPIMap

Individual provider Active NPI

Deborah E Degnan, PA-C

  • Physician Assistant
  • Fort Atkinson, WI
National Provider Identifier
1699737387
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1269 Issued in WI
Practice address
1504 Madison Ave
Fort Atkinson, WI 53538-3100
Phone
(920) 563-7888
Fax
(920) 563-7741
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 1269-023 WI
Physician Assistant 363A00000X 1269 WI Primary

Addresses

Primary practice location

1504 Madison Ave
Fort Atkinson, WI 53538-3100

Mailing address

PO Box 249
Fort Atkinson, WI 53538-0249
Phone (920) 568-5411

Other identifiers 1

IdentifierTypeStateIssuer
41933000MedicaidWI

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
I20041216000423 WI Practitioner - Physician Assistant 6406813914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

13900 W National Ave
New Berlin, WI 53151-9515
Phone (262) 928-4500

2130 Big Bend Rd
Waukesha, WI 53189-7624
Phone (262) 928-7555

721 American Ave
Waukesha, WI 53188-5071

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-1000

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

S69W15472 Janesville Rd
Muskego, WI 53150-9330
Phone (262) 928-7000

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1269-023WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince May 1, 2021 Accepting new patients
Prohealth Medical Group Inc CurrentSince May 1, 2021 Accepting new patients
Integrated Spine Care, S.C. PastSince Aug 1, 1998 Accepting new patients
Advanced Healthcare SC Past Accepting new patients
Advanced Pain Management SC Past Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

13900 W National Ave
New Berlin, WI 53151
Phone (262) 928-4500

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

721 American Ave
Ste 108
Waukesha, WI 53188
Phone (262) 928-2570

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

Organizations & group practices 16

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.

View all 16

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699737387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535380249",
            "telephone_number": "920-568-5411",
            "fax_number": "920-568-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 MADISON AVE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383100",
            "telephone_number": "920-563-7888",
            "fax_number": "920-563-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGNAN",
        "first_name": "DEBORAH",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1269-023",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41933000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

Verify at the official NPI Registry.