Individual provider Active NPI

Amanda Jo Shear, APNP

  • Nurse Practitioner
  • Summit, WI
National Provider Identifier
1104210988
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6294-33 Issued in WI
Practice address
36500 Aurora Dr
Summit, WI 53066-4899
Phone
(262) 434-1000
NPI assigned
Mar 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 174682-30 WI
Nurse Practitioner 363L00000X 6294-33 WI Primary

Addresses

Primary practice location

36500 Aurora Dr
Summit, WI 53066-4899

Mailing address

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

Other practice location 1

454 Herford Dr
Wales, WI 53183-9614
Phone (262) 441-4017

Other identifiers 1

IdentifierTypeStateIssuer
100047881MedicaidWI

Other names 1

  • Amanda Jo Gruchalski Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ashear51052@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
I20150522000765 WI Practitioner - Nurse Practitioner 7810217445 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
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
174682-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Dec 10, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 10, 2023 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Nurse Practitioner CurrentSince Jul 17, 2019 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Dcdo, Inc. PastSince Mar 20, 2007 Accepting new patients

Locations

19035 W Capitol Dr
Ste 100
Brookfield, WI 53045
Phone (262) 695-6744

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

5408 W Burleigh St
Milwaukee, WI 53210
Phone (414) 445-6520

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

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

201 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 259-7200

Organizations & group practices 5

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 2

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": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1104210988",
    "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": "36500 AURORA DR",
            "city": "SUMMIT",
            "state": "WI",
            "postal_code": "530664899",
            "telephone_number": "262-434-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "454 Herford Dr",
            "address_purpose": "LOCATION",
            "city": "Wales",
            "state": "WI",
            "postal_code": "531839614",
            "country_code": "US",
            "telephone_number": "262-441-4017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEAR",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "174682-30",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6294-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100047881",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashear51052@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "36500 Aurora Dr",
            "city": "Summit",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664899",
            "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": "36500 Aurora Dr",
            "city": "Summit",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "GRUCHALSKI",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Summit, WI

Sources for this page

Verify at the official NPI Registry.