Emily Becker, APRN

Key facts

NPI

1083065403

Entity type

Individual (NPI type 1)

Primary specialty

Nurse Practitioner 363L00000X

License

7577 (WI)

Practice address

N16W23217 Stone Ridge Dr. Suite 270
Pewaukee, WI 53188-1171

Phone

(262) 796-0600

Fax

(262) 796-0700

NPI assigned

Jun 27, 2016

Sex

Female

Sole proprietor

No

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.

• Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine Physician · Glendale, WI · NPI 1609881077
  Medicare reassignment NPD NURSE PRACTITIONER · WI
• Hometown Hospice & Homecare Inc Community Based Hospice Care Agency · Waukesha, WI · NPI 1508209438
  NPD
• Sacred Heart Rehabilitation Institute, Inc. Rehabilitation Hospital · Mequon, WI · NPI 1508920356
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Emily Boerneke Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 31, 2024.

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1083065403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N16W23217 STONE RIDGE DR. SUITE 270",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "531881171",
            "telephone_number": "262-796-0600",
            "fax_number": "262-796-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N16W23217 STONE RIDGE DR. SUITE 270",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "531881171",
            "telephone_number": "262-796-0600",
            "fax_number": "262-796-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "EMILY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "BOERNEKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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