Individual provider Active NPI

Alyssa Zimmermann, PA

  • Physician Assistant
  • Waupaca, WI
National Provider Identifier
1992679955
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
866123 Issued in WI
Practice address
800 Riverside Dr
Waupaca, WI 54981-1943
Phone
(715) 258-1000
NPI assigned
Oct 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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 866123 WI Primary

Addresses

Primary practice location

800 Riverside Dr
Waupaca, WI 54981-1943

Mailing address

1444 Pleasant Dr Apt 5
Plover, WI 54467-9136
Phone (651) 262-8297

Other names 1

  • Alyssa Reiter Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251106000491 WI Practitioner - Physician Assistant 3274023437 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3 Neenah Ctr
Neenah, WI 54956-3070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
866123WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Richard S Veiga MD SC Current Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Oct 10, 2025 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Oct 10, 2025 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. Physician Assistant CurrentSince Oct 10, 2025 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Oct 10, 2025 Accepting new patients

Locations

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

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

Organizations & group practices 6

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 3

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": "1759363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1992679955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 PLEASANT DR APT 5",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544679136",
            "telephone_number": "651-262-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811943",
            "telephone_number": "715-258-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "ALYSSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-02",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "866123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "REITER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waupaca, WI

Sources for this page

Verify at the official NPI Registry.