Individual provider Active NPI

Anna Rae Kitowicz, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Sun Prairie, WI
National Provider Identifier
1205604196
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
14469 Issued in WI
Practice address
160 Columbus St
Sun Prairie, WI 53590-2247
Phone
(608) 577-9062
NPI assigned
Dec 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14469 WI Primary

Addresses

Primary practice location

160 Columbus St
Sun Prairie, WI 53590-2247

Mailing address

160 Columbus St
Sun Prairie, WI 53590-2247
Phone (608) 577-9062

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
I20240927000756 WI Practitioner - Nurse Practitioner 3971034216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Affiliated Clinical Services IncGroup PAC ID 0244124899, 22 clinicians

Practice addresses (Care Compare)

111 E Washington St
West Bend, WI 53095-2571
Phone (262) 338-2717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Clinical Services Inc CurrentSince Jun 14, 2024 Accepting new patients

Locations

111 E Washington St
West Bend, WI 53095
Phone (262) 338-2717

Organizations & group practices 1

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": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1205604196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 COLUMBUS ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902247",
            "telephone_number": "608-577-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 COLUMBUS ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902247",
            "telephone_number": "608-577-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITOWICZ",
        "first_name": "ANNA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "14469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

Verify at the official NPI Registry.