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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MYA AMALIE LONNEBOTN
NPI 1982337432
Physician Assistant - Medical in Madison, WI

Active since July 01, 2022PECOS EnrolledAccepts Medicare Assignment
4621 EASTPARK BLVD, MADISON, WI 53718(608) 914-0800(608) 265-1726 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 15, 2026, Dec 18, 2024, Aug 6, 2024 (3 updates tracked since 2024).

About Mya Amalie Lonnebotn NPPES

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

MYA AMALIE LONNEBOTN (NPI 1982337432) is an individual medical provider in Madison, Wisconsin, licensed in Wisconsin (8021-23) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, is affiliated with Cgh Medical Center, and is a graduate of University Of Wisconsin School Of Medicine (2024).

NPPES Registry Identity

NPI1982337432
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMYA AMALIE LONNEBOTN
Location Address4621 EASTPARK BLVDMadison, WI 53718-2000
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531
Phone(608) 914-0800
Fax(608) 265-1726
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2024
Enumeration DateJuly 1, 2022
Last NPPES UpdateJuly 15, 20263 updates tracked since enumeration
NPPES CertifiedJuly 15, 2026
✔ NPI 1982337432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in WI · 8021-23
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 8021 (WI)
4621 EASTPARK BLVD, Madison, WI 53718
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW and more.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

Mya Amalie Lonnebotn 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 ID7618415407
PECOS Enrollment IDI20240812001389
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

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 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.
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.

Cgh Medical Center

Acute Care Hospitals · Sterling, IL
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number140043
Location100 East Lefevre RoadSterling, IL 61081 · Whiteside County
Emergency services Birthing friendly

Uw Health

Acute Care Hospitals · Rockford, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140228
Location1401 East State StreetRockford, IL 61104 · Winnebago County
Emergency services Birthing friendly

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520089
Location202 S Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Richland Hospital

Critical Access Hospitals · Richland Center, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521341
Location333 E Second StRichland Center, WI 53581 · Richland County
Emergency services

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.

PROF. CHARLENE JOAN SCHULZ M.S., DRPH
Genetic Counselor, MS
4621 EASTPARK BLVD
MADISON, WI 53718
Dane County (608) 504-4286
DANIELLE GILL PHARMACIST
Pharmacist
4621 EASTPARK BLVD
MADISON, WI 53718
Dane County (608) 914-0100
TAYLOR FLETCHER SLP
Speech-Language Pathologist
4621 EASTPARK BLVD
MADISON, WI 53718
Dane County (608) 916-0100
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Durable Medical Equipment & Medical Supplies
4621 EASTPARK BLVD
MADISON, WI 53718
Dane County (608) 914-0100
TRAVIS JORDAN DANIEL MS
Psychologist
4621 EASTPARK BLVD
MADISON, WI 53718
Dane County (608) 915-0100
MARIA JOSE BERNAL RIERA MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
4621 EASTPARK BLVD
MADISON, WI 53718
Dane County (608) 916-0300
DEVON MILLER
Internal Medicine (Hematology & Oncology)
4621 EASTPARK BLVD
MADISON, WI 53718
Dane County (608) 915-0100
BABAK VAKILI MD
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
4621 EASTPARK BLVD
MADISON, WI 53718
Dane County (608) 914-0800

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 Mya Lonnebotn's NPI number?

The NPI number for Mya Lonnebotn is 1982337432. It was assigned to this individual provider in the NPPES registry on July 1, 2022.

Where is Mya Lonnebotn located?

Mya Lonnebotn practices at 4621 Eastpark Blvd, Madison, WI 53718. The listed phone number is (608) 914-0800.

What is Mya Lonnebotn's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Mya Lonnebotn enrolled in Medicare?

Yes. Mya Lonnebotn 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 Mya Lonnebotn accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW, HealthPartners and Quartz and 1 other insurer list Mya Lonnebotn 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 Mya Lonnebotn affiliated with any hospitals?

According to CMS data, Mya Lonnebotn is affiliated with Cgh Medical Center, Uw Health, Unitypoint Health - Meriter, University Of Wi Hospitals & Clinics Authority and Richland Hospital.

When was this NPI record last updated?

The NPPES record for Mya Lonnebotn was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 days 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.