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

Q: 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.

Q: What is Amanda Douma's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Amanda Douma was last updated on June 3, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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: July 26, 2026.

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

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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

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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 Aspirus Health Plan, CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

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

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

St. Agnes Hospital Hospice

Acute Care Hospitals · Fond Du Lac, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520088

Location430 E Division StFond Du Lac, WI 54935 · Fond Du Lac 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.

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