NPIMap

Individual provider Active NPI

Brenda Winski, NP

  • Nurse Practitioner
  • Michigan City, IN
National Provider Identifier
1174711618
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71002517A Issued in IN
Practice address
1225 E Coolspring Ave
Michigan City, IN 46360-6312
Phone
(219) 878-5029
Fax
(219) 878-8493
NPI assigned
Oct 10, 2007
Last updated
Jul 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71002517A IN Primary

Addresses

Primary practice location

1225 E Coolspring Ave
Michigan City, IN 46360-6312

Mailing address

3434 47TH St Ste 200
Boulder, CO 80301-1817
Phone (303) 444-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20221027000271 CO Practitioner - Nurse Practitioner 5092890970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K2 Dermatology LLCGroup PAC ID 9638547474, 6 clinicians

Practice addresses (Care Compare)

3434 47TH St
Suite 200
Boulder, CO 80301-1817
Phone (303) 444-8100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
K2 Dermatology, LLC CurrentSince Jan 1, 2023 Accepting new patients
Healthpartners Medical Group, LLC Past Accepting new patients
Franciscan Physician Network PastSince Aug 1, 2011 Accepting new patients
Northern Indiana Dermatology and Skin Surgery Center Past Accepting new patients

Locations

3434 47th St
Ste 200
Boulder, CO 80301
Phone (303) 444-8100

Interoperability endpoints

  • Direct secure messaging: bwinski@kallgrenderm.emadirect.md

Organizations & group practices 4

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.

Hospital & facility affiliations 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1174711618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 47TH ST STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011817",
            "telephone_number": "303-444-8100",
            "fax_number": "303-444-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-878-5029",
            "fax_number": "219-878-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINSKI",
        "first_name": "BRENDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002517A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.