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SURGICAL ASSOCIATES, SC
NPI 1205515491
Physician Assistant in Wausau, WI

Active since July 14, 2023CLIA Certified · 2 labs
2400 PINE RIDGE BLVD, WAUSAU, WI 54401(715) 847-2022(715) 847-2775 Get Directions Write a Review

NPPES record last updated: July 14, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Surgical Associates, Sc NPPES

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

SURGICAL ASSOCIATES, SC (NPI 1205515491) is a healthcare organization registered as a physician assistant in Wausau, Wisconsin and active in the NPI registry since July 2023. The organization holds 2 active CLIA laboratory certificates and lists Kayanne Lehman, Access Manager, as its authorized official.

NPPES Registry Identity

NPI1205515491
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameSURGICAL ASSOCIATES, SC
Location Address2400 PINE RIDGE BLVDWausau, WI 54401-7803
Mailing Address2400 Pine Ridge BlvdWausau, WI 54401-7803 · (715) 847-2022 · Fax (715) 847-2775
Phone(715) 847-2022
Fax(715) 847-2775
Organization SubpartNo
Authorized OfficialKayanne LehmanAccess Manager · (715) 847-2022
Enumeration DateJuly 14, 2023
NPPES CertifiedJuly 14, 2023
✔ NPI 1205515491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2400 PINE RIDGE BLVD, Wausau, WI 54401
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2079886

Surgical Associates, Sc · Wausau, WI
Active · expires Jun 25, 2028
CLIA Number52D2079886
Laboratory TypePhysician Office
Certificate Effective DateJune 26, 2026
Certificate Expiration DateJune 25, 2028
Laboratory DirectorMr. Benjamin J. Herdrich
Laboratory Phone(715) 847-2022
Laboratory LocationSurgical Associates, Sc2400 Pine Ridge Blvd, Wausau, WI 54401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 52D2223710

Surgical Associates · Wausau, WI
Active · expires May 9, 2027
CLIA Number52D2223710
Laboratory TypeOffice Based Procedure Ce
Certificate Effective DateMay 10, 2025
Certificate Expiration DateMay 9, 2027
Laboratory DirectorDr. Jeremiah Olson
Laboratory Phone(715) 847-2022
Laboratory LocationSurgical Associates2606 Stewart Ave Ste 100, Wausau, WI 54401
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

MS. KATHY LYNNE OBERMANN ANP-BC APNP
Nurse Practitioner
2400 PINE RIDGE BLVD
WAUSAU, WI 54401
Marathon County (715) 847-2022
DR. CORRINE BLUMLING MILLER M.D.
Surgery
2400 PINE RIDGE BLVD
WAUSAU, WI 54401
Marathon County (715) 847-2022
DR. CHARLES R. ALDEN M.D.
Surgery
2400 PINE RIDGE BLVD
WAUSAU, WI 54401
Marathon County (715) 847-2022
TIFFANY ANN MILLER APRN
Nurse Practitioner
2400 PINE RIDGE BLVD
WAUSAU, WI 54401
Marathon County (715) 847-2022
DR. PAUL JOSEPH CHESTOVICH M.D.
Surgery
2400 PINE RIDGE BLVD
WAUSAU, WI 54401
Marathon County (715) 847-2022
LINDA BLUME CST/CSFA
Specialist/Technologist, Other (Surgical Assistant)
2400 PINE RIDGE BLVD
WAUSAU, WI 54401
Marathon County (715) 847-2022
SYDNEY ELIZABETH MOOTZ PA-C
Physician Assistant
2400 PINE RIDGE BLVD
WAUSAU, WI 54401
Marathon County (715) 847-2022
DANA DEMEIO CSFA
Specialist/Technologist, Other (Surgical Assistant)
2400 PINE RIDGE BLVD
WAUSAU, WI 54401
Marathon County (715) 847-2022

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 Surgical Associates, Sc's NPI number?

The NPI number for Surgical Associates, Sc is 1205515491. It was assigned to this organization in the NPPES registry on July 14, 2023.

Where is Surgical Associates, Sc located?

Surgical Associates, Sc is located at 2400 Pine Ridge Blvd, Wausau, WI 54401. The listed phone number is (715) 847-2022.

What is Surgical Associates, Sc's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Does Surgical Associates, Sc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Surgical Associates, Sc was last updated on July 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.