Individual provider Active NPI

Susan Mary Chen, APNP

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1265951651
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8135-33 Issued in WI
Practice address
210 W Capitol Dr
Milwaukee, WI 53212-1123
Phone
(414) 727-6320
NPI assigned
Sep 17, 2017
Last updated
Nov 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8135-33 WI Primary
Diabetes Educator Registered Nurse 163WD0400X 85188-30 WI

Addresses

Primary practice location

210 W Capitol Dr
Milwaukee, WI 53212-1123

Mailing address

1075 Heather LN
Hartford, WI 53027-9045
Phone (262) 623-1194

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
I20180504001020 WI Practitioner - Nurse Practitioner 0941564645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Systems IncGroup PAC ID 3678565116, 12 clinicians

Practice addresses (Care Compare)

220 W Capitol Dr
Milwaukee, WI 53212-1185
Phone (414) 727-6320

74 Eclipse Ctr
Beloit, WI 53511-3550
Phone (608) 361-0311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85188-30WIMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Community Health Centers, Inc. CurrentSince Apr 1, 2018 Accepting new patients
Outreach Community Health Centers, Inc CurrentSince Apr 1, 2018 Accepting new patients

Locations

210 W Capitol Dr
Glendale, WI 53212
Phone (414) 906-5306

220 W Capitol Dr
Glendale, WI 53212
Phone (414) 374-2400

3805B Spring St
Ste 140
Mount Pleasant, WI 53405
Phone (262) 637-0500

Interoperability endpoints

  • Direct secure messaging: schen105279@direct.ochin.org
  • Direct secure messaging: schen816666@direct.ochin.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, 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": "1505606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1265951651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 HEATHER LN",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530279045",
            "telephone_number": "262-623-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121123",
            "telephone_number": "414-727-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-17",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8135-33",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "WI",
            "license": "85188-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.