Individual provider Active NPI

Alyssa Sekadlo

  • Psychiatric/Mental Health Nurse Practitioner
  • West Bend, WI
National Provider Identifier
1043768724
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7239-33 Issued in WI
Practice address
111 E Washington St
West Bend, WI 53095-2571
Phone
(262) 338-2717
Fax
(262) 338-9767
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7239-33 WI Primary
Family Nurse Practitioner 363LF0000X 7239 WI

Addresses

Primary practice location

111 E Washington St
West Bend, WI 53095-2571

Mailing address

949 N 9TH St
Milwaukee, WI 53233-1422

Other practice location 1

949 N 9th St
Milwaukee, WI 53233-1422
Phone (414) 226-7169

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 15, 2024 through May 15, 2028

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 E Washington St
West Bend, WI 53095-2571

949 N 9TH St
Milwaukee, WI 53233-1422

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7239WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Best Self Counseling Center LLP PastSince Jan 31, 2021 Accepting new patients

Organizations & group practices 1

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1043768724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 N 9TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952571",
            "telephone_number": "262-338-2717",
            "fax_number": "262-338-9767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "949 N 9th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532331422",
            "country_code": "US",
            "telephone_number": "414-226-7169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEKADLO",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "7239-33",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.