NPIMap

Individual provider Active NPI

Heidi M Schaefer, PA

  • Physician Assistant
  • Baraboo, WI
National Provider Identifier
1861456261
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1254-023 Issued in WI
Practice address
707 14TH St
Baraboo, WI 53913-1539
Phone
(608) 356-1400
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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 1254-023 WI Primary

Addresses

Primary practice location

707 14TH St
Baraboo, WI 53913-1539

Mailing address

707 14TH St
Baraboo, WI 53913-1539
Phone (608) 356-1400

Other identifiers 4

IdentifierTypeStateIssuer
1009390OtherWIPHYS PLUS
70OtherWIDEANCARE PROV #
430688874016OtherWITRICARE PROV #
41922300MedicaidWI

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
I20040210000159 WI Practitioner - Physician Assistant 7416841614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

4480 W Spencer St
Appleton, WI 54915
Phone (920) 738-4800

710 Riverside Dr
Waupaca, WI 54981-1941
Phone (715) 256-3000

Hospital & facility affiliations

  • Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1254-023WIMDPhysician Assistant
1254WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Sep 6, 2016 Accepting new patients
Thedacare, Incorporated CurrentSince Sep 6, 2016 Accepting new patients
Richard S Veiga MD SC Current Accepting new patients
SSM Healthcare of Wi Inc Past Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients
SSM Health Treatment and Recovery Center Past Accepting new patients
SSM Healthcare of Wi Inc Past Accepting new patients

Locations

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

122 E College Ave
Appleton, WI 54911
Phone (920) 996-3264

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

710 Riverside Dr
Waupaca, WI 54981
Phone (715) 256-3000

Interoperability endpoints

  • Direct secure messaging: hschaefer61248@direct.thedacare.org

Organizations & group practices 8

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1861456261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 14TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131539",
            "telephone_number": "608-356-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 14TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131539",
            "telephone_number": "608-356-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "HEIDI",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1254-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYS PLUS",
            "identifier": "1009390",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEANCARE PROV #",
            "identifier": "70",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROV #",
            "identifier": "430688874016",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41922300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.