NPIMap

Individual provider Active NPI

Lisa Drew

  • Psychiatric/Mental Health Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1134530769
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5819 Issued in WI
Practice address
721 American Ave Ste 501
Waukesha, WI 53188-5071
Phone
(262) 928-4036
NPI assigned
May 16, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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

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
Prohealth Medical Group Inc 475 clinicians

Practice addresses (Care Compare)

13750 W National Ave
New Berlin, WI 53151-4588
Phone (262) 789-1699

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140825001584 WI Practitioner - Nurse Practitioner 5294644209 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5819WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc CurrentSince Apr 24, 2017 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Apr 24, 2017 Accepting new patients
Waukesha Health System, Inc. Past Accepting new patients
Purity Dialysis Centers Inc PastSince Apr 30, 2003 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

721 American Ave
Ste 501
Waukesha, WI 53188
Phone (262) 928-2396

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5819 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5819 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

721 American Ave Ste 501
Waukesha, WI 53188-5071

Mailing address

721 American Ave Ste 501
Waukesha, WI 53188-5071
Phone (262) 928-4036

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 26, 2024.

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1134530769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 AMERICAN AVE STE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885071",
            "telephone_number": "262-928-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 AMERICAN AVE STE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885071",
            "telephone_number": "262-928-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREW",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5819",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "5819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.