NPIMap

Individual provider Active NPI

Miguel Angel Barraza Chavez

  • Physician Assistant
  • Wautoma, WI
National Provider Identifier
1932832706
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
751223 Issued in WI
Practice address
400 S Townline Rd
Wautoma, WI 54982-6922
Phone
(920) 787-5514
NPI assigned
Jul 7, 2022
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 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 751223 WI Primary

Addresses

Primary practice location

400 S Townline Rd
Wautoma, WI 54982-6922

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (715) 256-3000

Other practice location 1

902 Riverside Dr
Waupaca, WI 54981-1992
Phone (715) 256-3000

Other practice location 2

115 Maple St
Waupaca, WI 54981-1210
Phone (920) 268-3221

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
I20231111000029 WI Practitioner - Physician Assistant 4789031899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

902 Riverside Dr
Suite 203
Waupaca, WI 54981-1992
Phone (715) 258-0242

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
751223WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Jan 1, 2026 Accepting new patients
La Clinica de Los Campesinos, Inc CurrentSince Oct 2, 2023 Accepting new patients
Thedacare Medical Center - Shawano, Inc. PastSince Jan 1, 2026 Accepting new patients

Locations

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

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

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

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

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

902 Riverside Dr
Ste 203
Waupaca, WI 54981
Phone (715) 258-0242

400 S Townline Rd
Wautoma, WI 54982
Phone (920) 647-8984

Interoperability endpoints

  • Direct secure messaging: mbarrazachavez233023@direct.ochin.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1932832706",
    "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": "715-256-3000",
            "fax_number": "715-256-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S TOWNLINE RD",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549826922",
            "telephone_number": "920-787-5514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811992",
            "country_code": "US",
            "telephone_number": "715-256-3000",
            "fax_number": "715-256-3028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Maple St",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811210",
            "country_code": "US",
            "telephone_number": "920-268-3221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRAZA CHAVEZ",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "751223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wautoma, WI

Sources for this page

Verify at the official NPI Registry.