Individual provider Active NPI

Kyungsook Yoon, AGPCNP-BC, APNP

  • Gerontology Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1083000160
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
6273-33 Issued in WI
Practice address
7733 W Burleigh St
Milwaukee, WI 53222-5003
Phone
(414) 837-6300
Fax
(414) 763-3602
NPI assigned
Apr 15, 2015
Last updated
Apr 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 6273-33 WI Primary

Addresses

Primary practice location

7733 W Burleigh St
Milwaukee, WI 53222-5003

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4100

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
I20150429002098 WI Practitioner - Nurse Practitioner 9133448988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milwaukee Internal Medicine Associates IncGroup PAC ID 6103908785, 12 clinicians

Practice addresses (Care Compare)

7733 W Burleigh St
Milwaukee, WI 53222-5003
Phone (414) 837-6300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6273-33WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Internal Medicine Associates Inc CurrentSince Mar 6, 2015 Accepting new patients

Locations

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

3415 Sheridan Rd
Kenosha, WI 53140
Phone (262) 633-4343

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

7733 W Burleigh St
Milwaukee, WI 53222
Phone (262) 328-4232

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1083000160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 W BURLEIGH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532225003",
            "telephone_number": "414-837-6300",
            "fax_number": "414-763-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "KYUNGSOOK",
        "credential": "AGPCNP-BC, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "6273-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.