Andrea Alexis Gordon, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8432-33 Issued in WI

Practice address

6308 8TH Avenue
Ste 202
Kenosha, WI 53143

Phone

(262) 653-5330

Fax

(262) 653-5346

NPI assigned

Mar 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Andrea Alexis Gallo Former name

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score

83.15 of 100Reported as group

Quality

69.39

Promoting interoperability

100

Improvement activities

40

Cost

74.44

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Froedtert South, Inc.

  • Family Medicine Physician
  • Kenosha, WI
  • NPI 1558305284
  Medicare reassignment Care Compare group NPD
• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  NPD (past)

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

• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  Care Compare affiliation

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530662400000",
    "number": "1306377023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVENUE, STE 202",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-653-5330",
            "fax_number": "262-653-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVENUE",
            "address_2": "STE 202",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53143",
            "telephone_number": "262-653-5330",
            "fax_number": "262-653-5346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9555 76th Street",
            "address_purpose": "LOCATION",
            "city": "Pleasant Prairie",
            "state": "WI",
            "postal_code": "531581984",
            "country_code": "US",
            "telephone_number": "262-653-5330",
            "fax_number": "262-653-5346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ANDREA",
        "middle_name": "ALEXIS",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2018-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "178314-030",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8432-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI LICENSE",
            "identifier": "8432-33",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306377023",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "GALLO",
            "middle_name": "ALEXIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steve Goldberg, LCSW
• Joshua Gomez, PTA
• Angela Gonzales
• Cesar D Gonzalez, DDS
• Barbara Lynn Goode-Baars, LMT,CIMI
• Goro Tsuchiya MD SC
• Andrew E Gottheardt, OTR/L, CHT
• Karen Cole Gottschalk, PT
• Traci M Gotz, PT
• William Grady, OD

• Nurse Practitioner in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.