Individual provider Active NPI

Kimberley G Van Buren, NP

  • Nurse Practitioner
  • Waterford, WI
National Provider Identifier
1275680290
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2030 Issued in WI
Practice address
818 Forrest Dr
Waterford, WI 53185-4577
Phone
(262) 514-3700
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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 2030 WI Primary

Addresses

Primary practice location

818 Forrest Dr
Waterford, WI 53185-4577

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 514-3700

Other identifiers 1

IdentifierTypeStateIssuer
43956900MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kvanburen47026@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20070206000236 WI Practitioner - Nurse Practitioner 6002818994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

818 Forest LN
Waterford, WI 53185-4585
Phone (262) 514-3700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 11, 2010 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 11, 2010 Accepting new patients
Aurora Quick Care, LLC Nurse Practitioner CurrentSince Jun 1, 2007 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1415 Lawrence Dr
#1
De Pere, WI 54115
Phone (920) 339-4328

9200 W Loomis Rd
Franklin, WI 53132
Phone (414) 529-9200

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

10932 N Port Washington Rd
Mequon, WI 53092
Phone (262) 240-0169

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2801 S Moorland Rd
New Berlin, WI 53151
Phone (262) 860-7800

607 Tyler Ave
Omro, WI 54963
Phone (920) 685-7400

9201 Washington Ave
Racine, WI 53406
Phone (262) 504-5471

915 Summit Ave
Summit, WI 53066
Phone (262) 569-2300

620 15th Ave
Union Grove, WI 53182
Phone (262) 878-1211

818 Forest Ln
Waterford, WI 53185
Phone (262) 514-3700

W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000

Interoperability endpoints

  • Direct secure messaging: kvanburen47026@direct.myadvocateaurora.org

Organizations & group practices 6

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 5

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1275680290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-514-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 FORREST DR",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531854577",
            "telephone_number": "262-514-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BUREN",
        "first_name": "KIMBERLEY",
        "middle_name": "G",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43956900",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvanburen47026@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "818 Forrest Dr",
            "city": "Waterford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531854577",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "818 Forrest Dr",
            "city": "Waterford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531854577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterford, WI

Sources for this page

Verify at the official NPI Registry.