Individual provider Active NPI

Kelley Ann Beltran, FNP

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1063949600
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7632 Issued in WI
Practice address
3727 W Wisconsin Ave
Milwaukee, WI 53208-3182
Phone
(414) 291-2626
NPI assigned
May 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7632 WI Primary

Addresses

Primary practice location

3727 W Wisconsin Ave
Milwaukee, WI 53208-3182

Mailing address

932 S 60TH St
Milwaukee, WI 53214-3369
Phone (414) 841-7567

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
I20170523001924 WI Practitioner - Nurse Practitioner 8022385046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Procare Medical Group SCGroup PAC ID 0840277265, 16 clinicians

Practice addresses (Care Compare)

3727 W Wisconsin Ave
Milwaukee, WI 53208-3182
Phone (414) 291-2626

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7632WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Medical Group SC CurrentSince Jun 1, 2017 Accepting new patients

Locations

3727 W Wisconsin Ave
Milwaukee, WI 53208
Phone (414) 291-2626

932 S 60th St
West Allis, WI 53214
Phone (414) 291-2626

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18762/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kelley.beltran.1@18762.direct.athenahealth.com

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": "1494720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1063949600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 S 60TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532143369",
            "telephone_number": "414-841-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083182",
            "telephone_number": "414-291-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "KELLEY",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-14",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "7632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.