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MRS. AMANDA KAY DOUMA APNP
NPI 1043697048
Nurse Practitioner - Family in New London, WI

Active since April 29, 2015PECOS EnrolledAccepts Medicare Assignment
1405 MILL ST, NEW LONDON, WI 54961(920) 531-2021 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 3, 2025, Mar 3, 2021, Mar 24, 2020 and 2 more (5 updates tracked since 2016).

About Mrs. Amanda Kay Douma Apnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. AMANDA KAY DOUMA APNP (NPI 1043697048) is an individual family provider in New London, Wisconsin, licensed in Wisconsin (6264) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1043697048
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. AMANDA KAY DOUMACredential: APNP
Location Address1405 MILL STNew London, WI 54961-2155
Mailing Address3 Neenah CtrNeenah, WI 54956-3070 · (920) 531-2021
Phone(920) 531-2021
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 29, 2015
Last NPPES UpdateJune 3, 20255 updates tracked since enumeration
NPPES CertifiedJune 3, 2025
✔ NPI 1043697048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in WI · 6264
1405 MILL ST, New London, WI 54961
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1333 N Green Bay Rd Ste BNeenah, WI 54956-1954 · Phone (920) 454-7130
Location 2420 E Division StFond Du Lac, WI 54935-4560 · Phone (920) 926-8570 · Fax (920) 926-8923

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Amanda Kay Douma Apnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739409954
PECOS Enrollment IDI20150528002432
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Amanda Douma reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Thedacare, Incorporated
Same address
Family Medicine
1405 MILL ST
New London, WI 54961
  • Reassigned Medicare billing, Wisconsin enrollment
  • 988 clinicians in this Medicare group
NPI 1376656959 (920) 830-5900
Thedacare Medical Center - Shawano, Inc.
25 mi
Critical Access
100 COUNTY ROAD B
Shawano, WI 54166
  • Reassigned Medicare billing, Wisconsin enrollment
  • 174 clinicians in this Medicare group
NPI 1548260839 (715) 526-2111
Agnesian Healthcare Inc
44 mi
Family Medicine
420 E DIVISION ST
Fond Du Lac, WI 54935
  • Reassigned Medicare billing, Wisconsin enrollment
  • 606 clinicians in this Medicare group
NPI 1730162991 (920) 923-7400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
36 services32 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
35 services31 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
22 services22 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
18 services17 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
16 services16 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
15 services15 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520045
Location130 2nd StNeenah, WI 54956 · Winnebago County
Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520160
Location1818 N Meade StAppleton, WI 54911 · Outagamie County
Emergency services Birthing friendly

Thedacare Medical Center - Wild Rose

Critical Access Hospitals · Wild Rose, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521303
Location601 Grove AveWild Rose, WI 54984 · Waushara County
Emergency services

Thedacare Medical Center - New London

Critical Access Hospitals · New London, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521326
Location1405 Mill StNew London, WI 54961 · Waupaca County
Emergency services

Thedacare Medical Center-Waupaca

Critical Access Hospitals · Waupaca, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521334
Location800 Riverside DriveWaupaca, WI 54981 · Waupaca County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54961 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SIERRA RENEE KACZOCHA
Physical Therapist
1405 MILL ST
NEW LONDON, WI 54961
Waupaca County (920) 531-2031
NATALIE G GAUTHIER APNP
Nurse Practitioner
1405 MILL ST
NEW LONDON, WI 54961
Waupaca County (920) 531-2400
COURTNEY NICOLE GARCIA PT
Physical Therapist
1405 MILL ST
NEW LONDON, WI 54961
Waupaca County (920) 531-2000
MRS. KIMBERLY ILEANA JACOBS OTR
Occupational Therapist
1405 MILL ST
NEW LONDON, WI 54961
Waupaca County (920) 531-2031
THEDACARE MEDICAL CENTER - NEW LONDON, INC.
Anesthesiology
1405 MILL ST
NEW LONDON, WI 54961
Waupaca County (920) 531-2092
MRS. JAYME M CWIK PTA
Physical Therapy Assistant
1405 MILL ST
NEW LONDON, WI 54961
Waupaca County (888) 982-3550
DR. JAMES MICHAEL DOOLIN RPH
Pharmacist
1405 MILL ST
NEW LONDON, WI 54961
Waupaca County (920) 531-2400
HEATHER A LUTZ APNP
Nurse Practitioner (Family)
1405 MILL ST
NEW LONDON, WI 54961
Waupaca County (920) 531-2400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Douma's NPI number?

The NPI number for Amanda Douma is 1043697048. It was assigned to this individual provider in the NPPES registry on April 29, 2015.

Where is Amanda Douma located?

Amanda Douma practices at 1405 Mill St, New London, WI 54961. The listed phone number is (920) 531-2021.

What is Amanda Douma's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Amanda Douma enrolled in Medicare?

Yes. Amanda Douma is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Amanda Douma's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Douma reassigns Medicare benefits to 3 organizations: Thedacare, Incorporated (New London, WI), Thedacare Medical Center - Shawano, Inc. (Shawano, WI) and Agnesian Healthcare Inc (Fond Du Lac, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amanda Douma's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Douma accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), Dean Health Plan and Security Health Plan list Amanda Douma as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Amanda Douma affiliated with any hospitals?

According to CMS data, Amanda Douma is affiliated with Thedacare Regional Med Ctr - Neenah, Thedacare Regional Medical Center - Appleton Inc, Thedacare Medical Center - Wild Rose, Thedacare Medical Center - New London and Thedacare Medical Center-Waupaca.

When was this NPI record last updated?

The NPPES record for Amanda Douma was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.