Individual provider Active NPI

Rebecca Merrill, NP

  • Nurse Practitioner
  • Oshkosh, WI
National Provider Identifier
1295518454
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14230 Issued in WI
Practice address
855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone
(920) 303-8700
NPI assigned
Aug 14, 2023
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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 14230 WI Primary

Addresses

Primary practice location

855 N Westhaven Dr
Oshkosh, WI 54904-7668

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (920) 303-8700

Other identifiers 1

IdentifierTypeStateIssuer
100250567MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rkwiesielewicz185975@aurora.direct-ci.com 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
I20230921001837 WI Practitioner - Nurse Practitioner 8820442023

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Chicago, IL 60673

PO Box
Suite 735044
Chicago, IL 60673-5044

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14230WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 23, 2023 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 23, 2023 Accepting new patients

Locations

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

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

Interoperability endpoints

  • Direct secure messaging: rkwiesielewicz185975@aurora.direct-ci.com

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.

Hospital & facility affiliations 1

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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1295518454",
    "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": "920-303-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047668",
            "telephone_number": "920-303-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "REBECCA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "14230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250567",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkwiesielewicz185975@aurora.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "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": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.