NPIMap

Individual provider Active NPI

Brooke A Henschel, APNP

  • Nurse Practitioner
  • Neenah, WI
National Provider Identifier
1245809714
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F06210791 Issued in WI
Practice address
100 Theda Clark Medical PLZ Ste 400
Neenah, WI 54956-2763
Phone
(920) 725-4527
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X F06210791 WI Primary

Addresses

Primary practice location

100 Theda Clark Medical PLZ Ste 400
Neenah, WI 54956-2763

Mailing address

100 Theda Clark Medical PLZ Ste 400
Neenah, WI 54956-2763
Phone (920) 725-4527

Other identifiers 1

IdentifierTypeStateIssuer
1245809714MedicaidWI

Other names 1

  • Brooke A Hiltunen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220107002303 WI Practitioner - Nurse Practitioner 6103218805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Neuroscience Group of Northeast Wisconsin SCGroup PAC ID 6204740186, 57 clinicians

Practice addresses (Care Compare)

1305 W American Dr
Neenah, WI 54956-1993
Phone (800) 201-1194

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06210791WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Neuroscience Group of Northeast Wisconsin SC Single Specialty CurrentSince Jun 5, 2023 Accepting new patients
Surgical Associates of Neenah, S.C. Single Specialty CurrentSince Oct 7, 2021 Accepting new patients

Locations

1305 West American Dr
Neenah, WI 54956
Phone (920) 729-7687

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

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

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

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

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1245809714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 THEDA CLARK MEDICAL PLZ STE 400",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562763",
            "telephone_number": "920-725-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 THEDA CLARK MEDICAL PLZ STE 400",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562763",
            "telephone_number": "920-725-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSCHEL",
        "first_name": "BROOKE",
        "middle_name": "A",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "F06210791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245809714",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "HILTUNEN",
            "middle_name": "A",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.