Gretchen Jean Gerovac, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

11896 Issued in WI

Practice address

257 W Saint George Ave
Grantsburg, WI 54840-7827

Phone

(715) 463-5353

NPI assigned

May 7, 2021

Last updated

Oct 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Burnett Medical Center IncGroup PAC ID 2163314931, shared by 4 NPIs, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Society - Home Care Home health agency, St Croix Falls, WI, CCN 527309
• Burnett Medical Center Hospital, Grantsburg, WI, CCN 521331
• St Croix Regional Medical Center Hospital, Saint Croix Falls, WI, CCN 521337

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggerovac641804@direct.ochin.org

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.

• Burnett Medical Center Inc

  • Critical Access Hospital
  • Grantsburg, WI
  • NPI 1225191687
  Medicare reassignment NPD
• Burnett Medical Center Inc

  dba Burnett Medical Center

  • Rural Health Clinic/Center
  • Grantsburg, WI
  • NPI 1356499784
  Medicare reassignment NPD
• Burnett Medical Center Inc

  • Skilled Nursing Facility
  • Grantsburg, WI
  • NPI 1487703815
  NPD

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

• Burnett Medical Center Inc

  • Critical Access Hospital
  • Grantsburg, WI
  • NPI 1225191687
  Care Compare affiliation
• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922
  Care Compare affiliation
• The Evangelical Lutheran Good Samaritan Society

  dba Good Samaritan Society - Home Care

  • Home Health Agency
  • Saint Croix Falls, WI
  • NPI 1568627156
  Care Compare affiliation

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1124602081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 W SAINT GEORGE AVE",
            "city": "GRANTSBURG",
            "state": "WI",
            "postal_code": "548407827",
            "telephone_number": "715-463-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 W SAINT GEORGE AVE",
            "city": "GRANTSBURG",
            "state": "WI",
            "postal_code": "548407827",
            "telephone_number": "715-463-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEROVAC",
        "first_name": "GRETCHEN",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "8158",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "11896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124602081",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Desktop",
            "affiliation": "N",
            "address_1": "257 W Saint George Ave",
            "city": "Grantsburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548407827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jenna Sue Fickbohm, L.P.N
• Robyn Marie Formanek, P.T.
• Jordan Fraser, DO
• Kathleen M French, PT
• Gary L Kaefer DDS SC
• Janelle R. Gomez, MSRDCD
• Debra Harris Hammer, CNM
• Brandie Marie Hanson, P.T.A.
• Linae Marie Hicks, RN
• Molly Ilstrup, NP

• Gerontology Nurse Practitioner in Grantsburg, WI
• Providers in Grantsburg, WI by specialty
• Gerontology Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.