Individual provider Active NPI

Luis-Alejandro Roldan Cubides, NP

  • Nurse Practitioner
  • New Berlin, WI
National Provider Identifier
1184101586
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8641 Issued in WI
Practice address
14555 W National Ave
New Berlin, WI 53151-4494
Phone
(844) 284-0381
NPI assigned
Jul 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209029946 IL
Family Nurse Practitioner 363LF0000X 8641-33 WI
Nurse Practitioner 363L00000X 8641 WI Primary

Addresses

Primary practice location

14555 W National Ave
New Berlin, WI 53151-4494

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

2801 W Kinnickinnic River Pkwy Ste 170
Milwaukee, WI 53215
Phone (414) 385-8600

Other practice location 2

9555 S 52nd Ave
Oak Lawn, IL 60453-3054
Phone (708) 634-0950

Other identifiers 1

IdentifierTypeStateIssuer
100082251MedicaidWI

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address lroldan31139@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address lroldan31139@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181011002846 WI Practitioner - Nurse Practitioner 3274885629 Reassigns benefits to 3 organizations
I20241007001423 IL Practitioner - Nurse Practitioner 3274885629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

100 W 162ND St
Advocate Med GRP S Holland
South Holland, IL 60473-2003
Phone (708) 730-2200

1441 Branding Ave
Downers Grove, IL 60515-5624
Phone (630) 829-1084

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600

350 Surryse Rd
Suite 100
Lake Zurich, IL 60047-3217
Phone (847) 438-2144

3900 W 203Rd St
Olympia Fields, IL 60461-3168
Phone (708) 679-2252

4001 Vollmer Rd
Olympia Fields, IL 60461-3168
Phone (708) 481-8883

4025 N Western Ave
Chicago, IL 60618-3726
Phone (773) 275-7700

77 Rand Rd
Des Plaines, IL 60016-1005
Phone (847) 294-5490

9550 W 167TH St
Orland Park, IL 60467-5561

9555 S 52ND Ave
Oak Lawn, IL 60453-3054
Phone (708) 634-0950

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8641WIMDNurse Practitioner
8641-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince May 14, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 25, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Feb 25, 2019 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Nov 10, 2022 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 29, 2024 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jun 29, 2024 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince May 14, 2024 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9555 S 52nd Ave
Oak Lawn, IL 60453
Phone (708) 422-5700

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

4448 W Loomis Rd
Milwaukee, WI 53220
Phone (414) 281-5150

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2801 W Kinnickinnic River Pkwy
Ste 170
Milwaukee, WI 53215
Phone (414) 385-1277

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: lroldan31139@direct.myadvocateaurora.org

Organizations & group practices 9

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": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1184101586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514494",
            "telephone_number": "844-284-0381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 170",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53215",
            "country_code": "US",
            "telephone_number": "414-385-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9555 S 52nd Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604533054",
            "country_code": "US",
            "telephone_number": "708-634-0950",
            "fax_number": "708-634-0942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLDAN CUBIDES",
        "first_name": "LUIS-ALEJANDRO",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-27",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209029946",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8641-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100082251",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lroldan31139@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 170",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lroldan31139@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 170",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.