Active NPI
Ellen A Humberston, PA-C
- Surgical Physician Assistant
- Wausau, WI
National Provider Identifier
1952961633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 2400 Pine Ridge Blvd
Wausau, WI 54401-7803 - Phone
- (715) 842-3196
- NPI assigned
- Jun 16, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Primary |
Addresses
Primary practice location
2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Mailing address
2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 847-2022
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, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3200 Westhill Dr
Suite 102
Wausau, WI 54401-4706
Phone (715) 847-2019
Hospital & facility affiliations
- Aspirus Wausau Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician 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.
-
- Diagnostic Radiology Physician
- Wausau, WI
- NPI 1588679450
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1558363986
-
- General Acute Care Hospital
- Stevens Point, WI
- NPI 1598375271
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1902923170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680048000000",
"number": "1952961633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 PINE RIDGE BLVD",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544017803",
"telephone_number": "715-847-2022",
"fax_number": "715-847-2775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 PINE RIDGE BLVD",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544017803",
"telephone_number": "715-842-3196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMBERSTON",
"first_name": "ELLEN",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-16",
"last_updated": "2023-03-29",
"certification_date": "2023-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
- Human Services Board Serving North Central Heatlh Care Facility
- Human Services Board Serving North Central Heatlh Care Facility
- Human Services Board Serving North Central Heatlh Care Facility
- Human Services Board Serving North Central Heatlh Care Facility
- Human Services Board Serving North Central Heatlh Care Facility
- John C Hunsicker, PA
- John Hupp II
- Thomas Craig Hupy, M.D.
- Linda Hurt, O.T.R.
- Alia Hussain, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.