Individual provider Active NPI

Lynne M Derezinski, APNP

  • Nurse Practitioner
  • Stevens Point, WI
National Provider Identifier
1205146222
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4200 Issued in WI
Practice address
2050 Fourth Avenue
Suite a
Stevens Point, WI 54481
Phone
(715) 346-4646
NPI assigned
Oct 8, 2010
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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 4200 WI Primary

Addresses

Primary practice location

2050 Fourth Avenue
Suite a
Stevens Point, WI 54481

Mailing address

2050 Fourth Avenue
Suite a
Stevens Point, WI 54481
Phone (715) 346-4646

Other identifiers 1

IdentifierTypeStateIssuer
4200OtherWIWI STATE LIC

Other names 1

  • Lynne M Waite Former name

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
I20110121000757 WI Practitioner - Nurse Practitioner 2163601220 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4200WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Jun 30, 2018 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Jun 30, 2018 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

190 Grand Seasons Dr
Waupaca, WI 54981
Phone (715) 258-3401

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1205146222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 FOURTH AVENUE",
            "address_2": "SUITE A",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-346-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 FOURTH AVENUE",
            "address_2": "SUITE A",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-346-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEREZINSKI",
        "first_name": "LYNNE",
        "middle_name": "M",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LIC",
            "identifier": "4200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNNE",
            "last_name": "WAITE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stevens Point, WI

Sources for this page

Verify at the official NPI Registry.