NPIMap

Individual provider Active NPI

Julie A Vajda, PAC

  • Physician Assistant
  • Appleton, WI
National Provider Identifier
1780677294
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1022023 Issued in WI
Practice address
3925 N Gateway Dr
Appleton, WI 54913-7863
Phone
(920) 702-6371
Fax
(920) 993-5037
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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 1022023 WI Primary

Addresses

Primary practice location

3925 N Gateway Dr
Appleton, WI 54913-7863

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900

Other practice location 1

430 E Division St
Fond du Lac, WI 54935-4560
Phone (920) 929-2300

Other identifiers 1

IdentifierTypeStateIssuer
41928400MedicaidWI

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
I20090402000253 WI Practitioner - Physician Assistant 0749337061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

101 Main St
Neenah, WI 54956-2570
Phone (920) 727-4200

1855 S Koeller St
Oshkosh, WI 54902-6186
Phone (920) 223-7000

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone (920) 454-8401

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000

Hospital & facility affiliations

  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Ascension NE Wisconsin - St Elizabeth Campus Hospital, Appleton, WI, CCN 520009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1022023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Specialists, S.C. CurrentSince Jul 1, 2022 Accepting new patients
Thedacare, Incorporated CurrentSince Feb 1, 2026 Accepting new patients
Ascension Calumet Hospital, Inc CurrentSince Feb 8, 2026 Accepting new patients
EMS Observation, S.C. PastSince Jun 5, 2022 Accepting new patients

Locations

3925 N Gateway Dr
Appleton, WI 54913
Phone (920) 702-6371

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

Organizations & group practices 4

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 7

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1780677294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N GATEWAY DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137863",
            "telephone_number": "920-702-6371",
            "fax_number": "920-993-5037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-929-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAJDA",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1022023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41928400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.