Sandra G Amadon, M.D.
Individual provider Active NPI Occupational Medicine Physician · Waukesha, WI
NPI 1699747394 · NPPES record last updated Apr 4, 2024
Key facts
- NPI
- 1699747394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Medicine Physician 2083X0100X
- License
- 35976 (WI)
- Practice address
- 240 Maple Ave
Prohealth Care Medical Associates Inc.
Waukesha, WI 53149-8475 - Phone
- (262) 928-1900
- NPI assigned
- Feb 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Medical College of Wisconsin, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prohealth Medical Group Inc
Practice addresses (Care Compare)
109 Air Park Dr
Watertown, WI 53094-7400
Phone (262) 928-5100
1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400
2900 Golf Rd
FL 3
Pewaukee, WI 53072-5449
Phone (262) 523-0310
N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704
Hospital & facility affiliations
- Waukesha Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100331000419 | WI | Practitioner - Family Practice | 5395871164 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35976 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Family Medicine | Current |
Accepting new patients |
| Prohealth Medical Group Inc. | Family Medicine | Current |
Accepting new patients |
| Prohealth Medical Group Inc | Family Medicine | Past | Accepting new patients |
| Watertown Physician Practices LLC | Past | Accepting new patients |
Locations
W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000
400 Bay View Rd
Mukwonago, WI 53149
Phone (262) 363-1900
240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900
1185 Corporate Center Dr
Ste 175
Oconomowoc, WI 53066
Phone (262) 928-6236
1185 Corporate Center Dr
Ste 150
Oconomowoc, WI 53066
Phone (262) 928-5000
2900 Golf Rd
Pewaukee, WI 53072
Phone (262) 513-7254
N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030
N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093
Interoperability endpoints
- samadon5039@direct.phci.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 35976 | WI | Yes |
| Family Medicine Physician | 207Q00000X | 35976 | WI |
Addresses
Primary practice location
240 Maple Ave
Prohealth Care Medical Associates Inc.
Waukesha, WI 53149-8475
Mailing address
240 Maple Ave
Prohealth Care Medical Associates Inc.
Waukesha, WI 53149-8475
Phone (262) 928-1900
Other providers in Waukesha, WI
- Benjamin Altgilbers
- Eve Altizer
- Alyssia Altobelli
- Lynne Sarah Alva
- Ivette M Alvarado
- Amani a Maguid MD SC
- American Current Care P.a.
- Sarah Amherdt
- Nathan Amos
- Angela Amundson
All providers in Waukesha, WI · Occupational Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.