Individual provider Active NPI

Marisa S Kreuzer, APRN

  • Adult Health Nurse Practitioner
  • Neenah, WI
National Provider Identifier
1205467800
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
10481 Issued in WI
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 725-0077
NPI assigned
Feb 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11005995 FL
Acute Care Nurse Practitioner 363LA2100X 10481 WI
Adult Health Nurse Practitioner 363LA2200X APRN11005995 FL
Adult Health Nurse Practitioner 363LA2200X 10481 WI Primary

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 725-0077

Other practice location 1

77 W Underwood St Ste 200
Orlando, FL 32806-1122
Phone (407) 649-6884

Other practice location 2

52 W Underwood St
Orlando, FL 32806-1110
Phone (321) 841-5111

Other practice location 3

2400 E Capitol Dr
Appleton, WI 54911-8728
Phone (920) 831-5050

Other names 1

  • Marisa Suzanne Kreuzer Other 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
I20231031002849 WI Practitioner - Nurse Practitioner 4688001951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

130 2ND St
Neenah, WI 54956-2883
Phone (920) 725-0077

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10481WIMDProfessional Counselor
11005995FLMDAcute Care Nurse Practitioner
APRN11005995FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of Neenah, S.C. CurrentSince Sep 19, 2023 Accepting new patients
Thedacare, Incorporated CurrentSince Nov 10, 2023 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

2400 E Capitol Dr
Appleton, WI 54911
Phone (920) 731-4101

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

100 Theda Clark Medical Plz
Ste 400
Neenah, WI 54956
Phone (414) 725-4527

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

100 Theda Clark Medical Plz
Neenah, WI 54956
Phone (920) 722-7747

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

Interoperability endpoints

  • Direct secure messaging: mkreuzer303702@direct.thedacare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1580515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1205467800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-725-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-725-0077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 W Underwood St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061122",
            "country_code": "US",
            "telephone_number": "407-649-6884",
            "fax_number": "407-245-7059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "52 W Underwood St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061110",
            "country_code": "US",
            "telephone_number": "321-841-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549118728",
            "country_code": "US",
            "telephone_number": "920-831-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREUZER",
        "first_name": "MARISA",
        "middle_name": "S",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-01",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11005995",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "10481",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11005995",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "10481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "KREUZER",
            "middle_name": "SUZANNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.