Alexandra L Widenski

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

15724-33 Issued in WI

Practice address

11101 W Lincoln Ave
Milwaukee, WI 53227-1133

Phone

(800) 767-4411

NPI assigned

Jan 12, 2024

Last updated

Oct 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Rogers Memorial Hospital IncorporatedGroup PAC ID 3476455809, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rogers Memorial Hospital Incorporated

  dba Rogers Behavioral Health

  • Psychiatric Hospital
  • Oconomowoc, WI
  • NPI 1053329581
  Medicare reassignment Care Compare group NPD
• Rogers Memorial Hospital Incorporated

  dba Rogers Behavioral Health

  • Clinic/Center
  • Skokie, IL
  • NPI 1689047607
  NPD (past)

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1154192623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34700 VALLEY RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664500",
            "telephone_number": "262-646-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 W LINCOLN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532271133",
            "telephone_number": "800-767-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34700 Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Oconomowoc",
            "state": "WI",
            "postal_code": "530664500",
            "country_code": "US",
            "telephone_number": "414-755-9683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2424 S 102nd St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532272106",
            "country_code": "US",
            "telephone_number": "800-767-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDENSKI",
        "first_name": "ALEXANDRA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "WI",
            "license": "253228-30",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "15724-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley R Wickenhauser-Grief, RDH
• Eliot Martin Wickliff, M.D.
• Christopher Thomas Wickman, MD
• Ethel May Wicks, RN
• Jeff Widell, MD
• Angela Widenski
• Amanda Clark Widing, M.D.
• Ashley Nicole Widmayer, MA, LPC, CSAC
• Steven J Wiebe, D.O.
• Daniel Nicholas Wieczorek

• Psychiatric/Mental Health Nurse Practitioner in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.