SARA FORMANKIEWICZ (PA-C) – Physician Assistant, NPI 1467902874
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for SARA FORMANKIEWICZ (PA-C)
515 22nd Ave
Monroe, WI 535661569
Phone: (608) 324-1000
Type: Location
Reedsburg Area Medical Center, 2000, North Dewey Avenue, Reedsburg, Town of Reedsburg, Sauk County, Wisconsin, 53959, United States
REEDSBURG, WI 539591049
Phone: (608) 768-3900
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-11-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20161130001987 | I | Physician Assistant | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 172 | 168 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 17 | 17 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 15 | 15 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 53566)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| - | WI | |
| Clinical Psychologist | WI | |
| - | WI | |
| P A T H O L O G Y | IL | |
| - | LA | |
| Emergency Medicine | WI | |
| A N E S T H E S I O L O G Y | WI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WI | |
| Nurse Practitioner | WI |
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