Hannah T Gracyalny, FNP-C

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

15471 Issued in WI

Practice address

2701 E Enterprise Ave
Appleton, WI 54913-7729

Phone

(920) 954-2551

NPI assigned

Jun 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hstefaniak294628@direct.thedacare.org

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.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  NPD (past)

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1023851771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E ENTERPRISE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137729",
            "telephone_number": "920-954-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 E ENTERPRISE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137729",
            "telephone_number": "920-954-2551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W5282 Amy Ave",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549157233",
            "country_code": "US",
            "telephone_number": "920-358-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 Deerwood Ave",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549567110",
            "country_code": "US",
            "telephone_number": "920-727-9982",
            "fax_number": "920-727-9983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACYALNY",
        "first_name": "HANNAH",
        "middle_name": "T",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "15471-33",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "15471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Gosz, OTR/L
• George Paul Gosz, RPH
• Lori Jean Gosz, RD, CD, CDE
• Elizabeth Gowin, LPC-IT
• Carol Marie Grabowski, MD
• Sarah Graham, BCBA
• Lance A Grammont, DO
• Grand View Family and Cosmetic Dentistry
• Carrie L Grant, LMT
• Elizabeth Rose Graser, BCBA

• Pediatric Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.