Individual provider Active NPI

Miwako Ogurek

  • Nurse Practitioner
  • Manitowoc, WI
National Provider Identifier
1194421842
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13817-33 Issued in WI
Practice address
3509 Dewey St
Manitowoc, WI 54220-5813
Phone
(920) 686-5731
NPI assigned
Feb 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 225200-30 WI
Family Nurse Practitioner 363LF0000X 13817-33 WI
Nurse Practitioner 363L00000X 13817-33 WI Primary

Addresses

Primary practice location

3509 Dewey St
Manitowoc, WI 54220-5813

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (920) 793-7000

Other identifiers 1

IdentifierTypeStateIssuer
100242248MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mogurek91221@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
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

Enrollment IDStateProvider typePAC IDDetails
I20230712004311 WI Practitioner - Nurse Practitioner 7517327208 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2219 Garfield St
Two Rivers, WI 54241-2416
Phone (920) 793-6317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
225200-30WIMDRegistered Nurse
13817-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Jun 27, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 27, 2024 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jun 27, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 27, 2024 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jun 27, 2024 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince May 30, 2023 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

3509 Dewey St
Manitowoc, WI 54220
Phone (920) 686-5731

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

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

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

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

2219 Garfield St
Two Rivers, WI 54241
Phone (920) 793-2281

Organizations & group practices 6

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": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1194421842",
    "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": "920-793-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 DEWEY ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205813",
            "telephone_number": "920-686-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUREK",
        "first_name": "MIWAKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "225200-30",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "13817-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13817-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100242248",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mogurek91221@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3509 Dewey St",
            "city": "Manitowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542205813",
            "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": "3509 Dewey St",
            "city": "Manitowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542205813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.