Individual provider Active NPI

Jennifer Hidalgo Hruz

  • Family Nurse Practitioner
  • Brookfield, WI
National Provider Identifier
1003363870
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016013734 Issued in WI
Practice address
12625 W Burleigh Rd
Brookfield, WI 53005-3157
Phone
(262) 777-8482
Fax
(262) 333-2142
NPI assigned
Sep 8, 2016
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016013734 WI Primary

Addresses

Primary practice location

12625 W Burleigh Rd
Brookfield, WI 53005-3157

Mailing address

12625 W Burleigh Rd
Brookfield, WI 53005-3157
Phone (262) 777-8482

Other names 1

  • Ms. Jennifer Elaine Hidalgo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016013734WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acu-Med Integrative Medicine LLC CurrentSince Sep 22, 2016 Accepting new patients
Acu-Med Integrative Medicine LLC CurrentSince Nov 3, 2019 Accepting new patients

Locations

1428 E Racine Ave
Waukesha, WI 53186
Phone (262) 269-5107

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1003363870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 W BURLEIGH RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053157",
            "telephone_number": "262-777-8482",
            "fax_number": "262-333-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 W BURLEIGH RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053157",
            "telephone_number": "262-777-8482",
            "fax_number": "262-333-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRUZ",
        "first_name": "JENNIFER",
        "middle_name": "HIDALGO",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2016013734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HIDALGO",
            "middle_name": "ELAINE",
            "prefix": "MS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.