Individual provider Active NPI

Kasandra Flasch

  • Nurse Practitioner
  • Lomira, WI
National Provider Identifier
1093190860
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6427-033 Issued in WI
Practice address
375 East Ave
Lomira, WI 53048-9202
Phone
(920) 269-2060
NPI assigned
Jul 22, 2015
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6427-033 WI Primary

Addresses

Primary practice location

375 East Ave
Lomira, WI 53048-9202

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8200

Other identifiers 1

IdentifierTypeStateIssuer
100048397MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kflasch394810@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2

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
I20150925000947 WI Practitioner - Nurse Practitioner 5890003784 Reassigns benefits to 2 organizations

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
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

375 E Ave
Lomira, WI 53048-9202
Phone (920) 269-2060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6427-033WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 30, 2017 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 30, 2017 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 1, 2024 Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

375 East Ave
Lomira, WI 53048
Phone (920) 269-2060

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1093190860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 EAST AVE",
            "city": "LOMIRA",
            "state": "WI",
            "postal_code": "530489202",
            "telephone_number": "920-269-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-926-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLASCH",
        "first_name": "KASANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-22",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6427-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100048397",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kflasch394810@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "375 East Ave",
            "city": "Lomira",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530489202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "375 East Ave",
            "city": "Lomira",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530489202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lomira, WI

Sources for this page

Verify at the official NPI Registry.