Active NPI
Paige Danielle Bevers, PA
- Surgery Physician
- Neenah, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 5461-23
- Practice address
- 100 Theda Clark Medical PLZ Ste 400
Neenah, WI 54956-2763 - Phone
- (920) 725-4527
- NPI assigned
- Mar 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5461-23 | WI | Primary |
Addresses
Primary practice location
100 Theda Clark Medical PLZ Ste 400
Neenah, WI 54956-2763
Mailing address
100 Theda Clark Medical PLZ
Ste 400
Neenah, WI 54956-2763
Phone (920) 725-4527
Other names 1
- Paige Danielle Reynebeau
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763
Phone (920) 725-4527
130 2ND St
Neenah, WI 54956-2883
Phone (920) 729-3100
1405 Mill St
New London, WI 54961-2155
Phone (920) 531-2099
800 Riverside Dr
Waupaca, WI 54981-1943
Phone (920) 725-4527
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5461-23 | WI | MD | Surgery Physician |
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.
-
- Surgery Physician
- Neenah, WI
- NPI 1285792341
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Clintonville, WI
- NPI 1144675745
-
- Critical Access Hospital
- New London, WI
- NPI 1538127220
-
- Critical Access Hospital
- Waupaca, WI
- NPI 1013995521
-
- Critical Access Hospital
- Waupaca, WI
- NPI 1710333893
-
- General Acute Care Hospital
- Neenah, WI
- NPI 1023472842
-
- General Acute Care Hospital
- Menasha, WI
- NPI 1720434806
-
- General Acute Care Hospital
- Neenah, WI
- NPI 1518993880
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1861943409
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1679937494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681171200000",
"number": "1801471941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 THEDA CLARK MEDICAL PLZ",
"address_2": "STE 400",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562763",
"telephone_number": "920-725-4527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 THEDA CLARK MEDICAL PLZ STE 400",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562763",
"telephone_number": "920-725-4527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEVERS",
"first_name": "PAIGE",
"middle_name": "DANIELLE",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-10",
"last_updated": "2023-04-11",
"certification_date": "2023-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "5461-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PAIGE",
"last_name": "REYNEBEAU",
"middle_name": "DANIELLE",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.