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ALEXA MARY CLARE GAVAGA
NPI 1093166266
Internal Medicine in Oconto Falls, WI

Active since June 28, 2016PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
835 S MAIN ST STE 1, OCONTO FALLS, WI 54154(920) 855-2823 Get Directions Write a Review

NPPES record last updated: August 30, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 30, 2019, Jun 28, 2016 (2 updates tracked since 2016).

About Alexa Mary Clare Gavaga NPPES

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

ALEXA MARY CLARE GAVAGA (NPI 1093166266) is an individual internal medicine provider in Oconto Falls, Wisconsin, licensed in Wisconsin (70162-20) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and maintains a secondary practice location in Jersey City.

NPPES Registry Identity

NPI1093166266
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameALEXA MARY CLARE GAVAGA
Location Address835 S MAIN ST STE 1Oconto Falls, WI 54154-1282
Mailing Address835 S Main St, Ste 1Oconto Falls, WI 54154-1282 · (201) 515-7883
Phone(920) 855-2823
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 28, 2016
Last NPPES UpdateAugust 30, 20192 updates tracked since enumeration
✔ NPI 1093166266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 70162-20
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
835 S MAIN ST STE 1, Oconto Falls, WI 54154
Open in Google Maps ↗

Secondary Practice Location 1

Location 1355 Grand StJersey City, NJ 07302-4321 · Phone (201) 915-2431

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Security Health Plan.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

Alexa Mary Clare Gavaga 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 ID4789913112
PECOS Enrollment IDI20190911000663
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 10

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.

Dxa bone density measurement of hip, pelvis, spine 77080
A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
145 services145 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
138 services83 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.
136 services82 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
42 services42 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
41 services35 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.
39 services30 patients

Hospital Affiliations CMS Care Compare 3

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520097
Location1726 Shawano AveGreen Bay, WI 54303 · Brown County
Emergency services

Hshs St Clare Memorial Hospital

Critical Access Hospitals · Oconto Falls, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521310
Location855 S Main StOconto Falls, WI 54154 · Oconto County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54154 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers18 claims38 services$5.91 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers13 claims13 services$16.16 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers11 claims11 services$84.60 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

MRS. LISA MAY FONDER FNP-C, APNP
Nurse Practitioner (Family)
835 S MAIN ST STE 1
OCONTO FALLS, WI 54154
Oconto County (920) 496-4700
KAITLYN ELIZABETH SHARBONEAU FNP-C
Nurse Practitioner (Family)
835 S MAIN ST STE 1
OCONTO FALLS, WI 54154
Oconto County (920) 846-8187

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 Alexa Gavaga's NPI number?

The NPI number for Alexa Gavaga is 1093166266. It was assigned to this individual provider in the NPPES registry on June 28, 2016.

Where is Alexa Gavaga located?

Alexa Gavaga practices at 835 S Main St Ste 1, Oconto Falls, WI 54154. The listed phone number is (920) 855-2823.

What is Alexa Gavaga's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Alexa Gavaga enrolled in Medicare?

Yes. Alexa Gavaga 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.

What insurance does Alexa Gavaga accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and Security Health Plan list Alexa Gavaga 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 Alexa Gavaga affiliated with any hospitals?

According to CMS data, Alexa Gavaga is affiliated with St Vincent Hospital, St Mary's Hospital Medical Center and Hshs St Clare Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Alexa Gavaga was last updated on August 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.