NPIMap

Individual provider Active NPI

Amy Jo Hanneman, RN MSN AGNP

  • Adult Health Nurse Practitioner
  • Wausau, WI
National Provider Identifier
1750770640
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
113915-30 Issued in WI
Practice address
425 Pine Ridge Blvd
Suite 300
Wausau, WI 54401-4123
Phone
(715) 847-2019
Fax
(715) 843-1315
NPI assigned
Jan 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 113915-30 WI Primary
Gerontology Nurse Practitioner 363LG0600X 113915-30 WI

Addresses

Primary practice location

425 Pine Ridge Blvd
Suite 300
Wausau, WI 54401-4123

Mailing address

425 Pine Ridge Blvd
Suite 300
Wausau, WI 54401-4123
Phone (715) 847-2019

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
I20150608001737 WI Practitioner - Nurse Practitioner 7012238686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medical Group, Inc.Group PAC ID 1052223625, 272 clinicians

Practice addresses (Care Compare)

4005 Community Ctr Dr
Weston, WI 54476-4139
Phone (715) 241-5400

425 Pine Ridge Blvd
Wausau, WI 54401-4123

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
  • Aspirus Medford Hospital & Clinics, Inc Hospital, Medford, WI, CCN 521324
  • Aspirus Rhinelander Hospital Hospital, Rhinelander, WI, CCN 520019
  • Aspirus Stevens Point Hospital & Clinics, Inc. Hospital, Stevens Point, WI, CCN 520002
  • Aspirus Riverview Hospital & Clinics Inc Hospital, Wisconsin Rapids, WI, CCN 520033

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40
Cost
78.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
113915-30WIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medical Group, Inc. CurrentSince May 4, 2015 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Dec 11, 2016 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince May 4, 2015 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Dec 11, 2016 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

425 Pine Ridge Blvd
Ste 300
Wausau, WI 54401
Phone (715) 847-0402

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Interoperability endpoints

  • Direct secure messaging: ahanneman105462@direct.aspirus.org

Organizations & group practices 7

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1750770640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 300",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-847-2019",
            "fax_number": "715-843-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 300",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-847-2019",
            "fax_number": "715-843-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNEMAN",
        "first_name": "AMY",
        "middle_name": "JO",
        "credential": "RN MSN AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "113915-30",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "113915-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.