Individual provider Active NPI

Amy Rose Poetz, R.D., C.D.

  • Registered Dietitian
  • Menomonee Falls, WI
National Provider Identifier
1144677261
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1093096 Issued in WI
Practice address
W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone
(262) 257-3135
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1093096 WI Primary

Addresses

Primary practice location

W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518

Mailing address

2404 Skyline Dr
West Bend, WI 53090-1147
Phone (262) 257-3135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210210001535 WI Practitioner - Registered Dietitian Or Nutrition Professional 2163837873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1093096WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Oct 27, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Oct 27, 2020 Accepting new patients
Froedtert & the Medical College of Wisconsin Community Physicians Inc. Past Accepting new patients

Locations

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

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

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 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1144677261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 SKYLINE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901147",
            "telephone_number": "262-257-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W180N8085 TOWN HALL RD",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513518",
            "telephone_number": "262-257-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POETZ",
        "first_name": "AMY",
        "middle_name": "ROSE",
        "credential": "R.D., C.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1093096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.