Ami Mantych, APNP
NPI 1417818030ActiveIndividual· Nurse Practitioner, Family· Beaver Dam, WI
Nurse Practitioner, Family (APNP) in Beaver Dam, Wisconsin, licensed in WI, with an NPI issued in November 2025. Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1417818030 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | APNP |
| Sole proprietor | No |
| NPI issued | Nov 21, 2025 |
| Last updated in NPPES | Aug 26, 2026 |
| Certified by provider | Aug 26, 2026 |
| Reactivated | Aug 21, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 18755-33 | WI |
| Family Medicine | 207Q00000X | 164101 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (WI) |
|---|
Education and affiliations
| Graduation year | 2026 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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