Individual provider Active NPI

Allison R Sajdak Hetzel, APNP

  • Nurse Practitioner
  • West Bend, WI
National Provider Identifier
1174831150
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4175 Issued in WI
Practice address
1100 Gateway CT
West Bend, WI 53095-8539
Phone
(262) 335-8600
Fax
(262) 335-2100
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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 4175 WI Primary

Addresses

Primary practice location

1100 Gateway CT
West Bend, WI 53095-8539

Mailing address

1100 Gateway CT
West Bend, WI 53095-8539
Phone (262) 335-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4175WIMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: asajdakhetzel28578@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1174831150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GATEWAY CT",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958539",
            "telephone_number": "262-335-8600",
            "fax_number": "262-335-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GATEWAY CT",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958539",
            "telephone_number": "262-335-8600",
            "fax_number": "262-335-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAJDAK HETZEL",
        "first_name": "ALLISON",
        "middle_name": "R",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.