Individual provider Active NPI

Amy Marie Hansen, FNP-C

  • Primary Care Nurse Practitioner
  • Hayward, WI
National Provider Identifier
1043105372
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
16866-33 Issued in WI
Practice address
11040 N State Rd 77
Hayward, WI 54843-3606
Phone
(715) 934-4910
NPI assigned
Jun 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 16866-33 WI Primary

Addresses

Primary practice location

11040 N State Rd 77
Hayward, WI 54843-3606

Mailing address

11040 N State Rd 77
Hayward, WI 54843-3606
Phone (715) 934-4910

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
I20250822003447 WI Practitioner - Nurse Practitioner 4183124274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Services, IncGroup PAC ID 9436061363, 32 clinicians

Practice addresses (Care Compare)

11040 N State Rd
Suite 77
Hayward, WI 54843-3606

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16866-33WIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Services, Inc CurrentSince Aug 1, 2025 Accepting new patients
Medical Services, Inc CurrentSince Aug 1, 2025 Accepting new patients
Medical Services, Inc Past Accepting new patients

Locations

43785 US Highway 63
Cable, WI 54821
Phone (715) 934-4970

11040 N State Road 77
Hayward, WI 54843
Phone (715) 934-4244

Organizations & group practices 3

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": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1043105372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11040 N STATE RD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433606",
            "telephone_number": "715-934-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11040 N STATE RD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433606",
            "telephone_number": "715-934-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "16866-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, WI

Sources for this page

Verify at the official NPI Registry.