Individual provider Active NPI

Gabrielle Marie Jensen, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wausau, WI
National Provider Identifier
1003673104
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
14888-33 Issued in WI
Practice address
500 N 3Rd St Ste 300
Wausau, WI 54403-4873
Phone
(800) 767-4411
NPI assigned
Mar 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14888-33 WI Primary

Addresses

Primary practice location

500 N 3Rd St Ste 300
Wausau, WI 54403-4873

Mailing address

34700 Valley Rd
Oconomowoc, WI 53066-4500
Phone (262) 646-4411

Other names 1

  • Gabrielle Marie Weber 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
I20240718001431 WI Practitioner - Nurse Practitioner 9335685064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Rogers Memorial Hospital IncorporatedGroup PAC ID 3476455809, 46 clinicians

Practice addresses (Care Compare)

2424 S 102ND St
West Allis, WI 53227-2106
Phone (800) 767-4411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14888-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Memorial Hospital Incorporated CurrentSince Nov 25, 2024 Accepting new patients
Rogers Memorial Hospital Incorporated Past Accepting new patients

Locations

34700 Valley Rd
Oconomowoc, WI 53066

11101 W Lincoln Ave
West Allis, WI 53227
Phone (414) 203-4500

2424 S 102nd St
West Allis, WI 53227
Phone (414) 373-7474

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.

NPI Registry JSON

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1003673104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-4411",
            "fax_number": "262-646-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 3RD ST STE 300",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544034873",
            "telephone_number": "800-767-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "GABRIELLE",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "14888-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "WEBER",
            "middle_name": "MARIE",
            "credential": "PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.