Individual provider Active NPI

Nichole N Sciaccotta, APNP

  • Nurse Practitioner
  • New Berlin, WI
National Provider Identifier
1093377905
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10067 Issued in WI
Practice address
14555 W National Ave
New Berlin, WI 53151-4494
Phone
(844) 284-0381
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10067 WI Primary
Nurse Practitioner 363L00000X 209019549 IL

Addresses

Primary practice location

14555 W National Ave
New Berlin, WI 53151-4494

Mailing address

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

Other practice location 1

633 Ridgeview Dr
McHenry, IL 60050-7012
Phone (815) 344-0621

Other practice location 2

1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624
Phone (262) 693-4311

Other identifiers 1

IdentifierTypeStateIssuer
1093377905MedicaidWI

Other names 1

  • Nichole Clark Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nclark382270@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 IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190710000954 IL Practitioner - Nurse Practitioner 6800121062 Reassigns benefits to 2 organizations
I20200609000464 WI Practitioner - Nurse Practitioner 6800121062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

633 Ridgeview Dr
McHenry, IL 60050-7012
Phone (815) 344-0621

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10067WIMDNurse Practitioner
209019549ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Aug 25, 2023 Accepting new patients
Journeycare, Inc. CurrentSince Jul 7, 2019 Accepting new patients
Journeycare, Inc CurrentSince Jul 7, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 8, 2026 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 8, 2026 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 25, 2023 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

2050 Claire Ct
Glenview, IL 60025
Phone (847) 467-7425

633 Ridgeview Dr
McHenry, IL 60050
Phone (815) 344-0621

405 Lake Zurich Rd
North Barrington, IL 60010
Phone (847) 381-5599

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

14555 W National Ave
#195B
New Berlin, WI 53151
Phone (262) 827-3290

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1093377905",
    "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": "14555 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514494",
            "telephone_number": "844-284-0381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "633 Ridgeview Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600507012",
            "country_code": "US",
            "telephone_number": "815-344-0621",
            "fax_number": "815-344-0664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1441 Branding Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605155624",
            "country_code": "US",
            "telephone_number": "262-693-4311",
            "fax_number": "414-203-3788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCIACCOTTA",
        "first_name": "NICHOLE",
        "middle_name": "N",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10067",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019549",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093377905",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nclark382270@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "633 Ridgeview Dr",
            "city": "McHenry",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600507012",
            "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": "633 Ridgeview Dr",
            "city": "McHenry",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600507012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.