Individual provider Active NPI

Abigail L Wonderly, PA

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1780463232
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.008447RX Issued in OH
Practice address
33 W Rahn Rd
Dayton, OH 45429-2219
Phone
(937) 433-8990
NPI assigned
Sep 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.008447RX OH Primary

Addresses

Primary practice location

33 W Rahn Rd
Dayton, OH 45429-2219

Mailing address

33 W Rahn Rd
Dayton, OH 45429-2219
Phone (937) 433-8990

Other names 1

  • Abigail L Ewald Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20231201001326 OH Practitioner - Physician Assistant 1658729652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Dayton Acute Care Consultants, IncGroup PAC ID 3577452465, 116 clinicians

Practice addresses (Care Compare)

2150 Leiter Rd
Miamisburg, OH 45342-3809
Phone (937) 384-8300

33 W Rahn Rd
Dayton, OH 45429-2219

3535 Pentagon Park Blvd
Beavercreek, OH 45431-1705
Phone (937) 352-2241

3535 Southern Blvd
Dayton, OH 45429-1221
Phone 93729843315425

Hospital & facility affiliations

  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Merit-based Incentive Payment System (MIPS)

Final score
91.82 of 100Reported as group
Quality
79.31
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.008447RXOHMDPhysician Assistant

Organizations & group practices 1

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 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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1780463232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W RAHN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292219",
            "telephone_number": "937-433-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W RAHN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292219",
            "telephone_number": "937-433-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONDERLY",
        "first_name": "ABIGAIL",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008447RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "EWALD",
            "middle_name": "L",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.