Annette Bennett-Otto

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8381-33 Issued in WI

Practice address

2717 N Grandview Blvd
Waukesha, WI 53188-1672

Phone

(262) 513-0700

Fax

(262) 513-0707

NPI assigned

Aug 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Practice roles

Locations

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.

• Agrace Palliative Care LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Fitchburg, WI
  • NPI 1326386129
  Medicare reassignment NPD

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1073067583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W532 ROME OAK HILL RD",
            "city": "PALMYRA",
            "state": "WI",
            "postal_code": "531569729",
            "telephone_number": "815-342-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 N GRANDVIEW BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881672",
            "telephone_number": "262-513-0700",
            "fax_number": "262-513-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT-OTTO",
        "first_name": "ANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8381-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Bridget Belter, RD
• Carole P Bender, RD
• Claire M Benishek, PAC
• Laurie B.D. Benkley, NP-C
• Evan Charles Benner, DO
• Virginia Bennett, PUBLIC HEALTH TECH
• Skye L Benthien
• Andriy Bereshnyy
• Caylen Nicole Berg
• Cecilia Rose Berg

• Nurse Practitioner in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.