Individual provider Active NPI

Lindsey Marie Mena, FNP

  • Nurse Practitioner
  • South Milwaukee, WI
National Provider Identifier
1003580044
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10902-33 Issued in WI
Practice address
3601 S Chicago Ave
South Milwaukee, WI 53172-3708
Phone
(414) 764-4100
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10902-33 WI Primary

Addresses

Primary practice location

3601 S Chicago Ave
South Milwaukee, WI 53172-3708

Mailing address

112 Holly LN
South Milwaukee, WI 53172-1019

Other names 1

  • Lindsey Marie Faist Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006002159 WI Practitioner - Nurse Practitioner 6507264462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milwaukee Internal Medicine Associates IncGroup PAC ID 6103908785, 12 clinicians

Practice addresses (Care Compare)

3601 S Chicago Ave
South Milwaukee, WI 53172-3708
Phone (414) 764-4100

Hospital & facility affiliations

  • Preceptor Home Health Home health agency, Germantown, WI, CCN 527313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10902-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Internal Medicine Associates Inc CurrentSince Aug 18, 2021 Accepting new patients

Locations

7733 W Burleigh St
Milwaukee, WI 53222
Phone (262) 328-4232

3601 S Chicago Ave
South Milwaukee, WI 53172
Phone (414) 570-5477

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1003580044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HOLLY LN",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S CHICAGO AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531723708",
            "telephone_number": "414-764-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA",
        "first_name": "LINDSEY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10902-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "FAIST",
            "middle_name": "MARIE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.