Individual provider Active NPI

Inna Dulkin

  • Family Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1306428107
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10911-33 Issued in WI
Practice address
725 American Ave
Waukesha, WI 53188-5031
Phone
(262) 928-2594
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10911-33 WI Primary

Addresses

Primary practice location

725 American Ave
Waukesha, WI 53188-5031

Mailing address

10870 N Highlander CT
Mequon, WI 53097-3403
Phone (262) 353-0875

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL inna.dulkin@phci.org

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
I20210512000823 WI Practitioner - Nurse Practitioner 3274942875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-3500

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10911-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc CurrentSince May 1, 2021 Accepting new patients
Prohealth Medical Group Inc. CurrentSince May 1, 2021 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

195 Discovery Dr
Brookfield, WI 53045
Phone (262) 513-7100

195 Discovery Dr
Fl 2
Brookfield, WI 53045

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

785 Summit Ave
Ste 101
Summit, WI 53066
Phone (262) 567-5385

725 American Ave
Fl 3
Waukesha, WI 53188
Phone (262) 928-2594

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Organizations & group practices 4

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 3

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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1306428107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10870 N HIGHLANDER CT",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530973403",
            "telephone_number": "262-353-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AMERICAN AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885031",
            "telephone_number": "262-928-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULKIN",
        "first_name": "INNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10911-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "inna.dulkin@phci.org",
            "affiliation": "N",
            "address_1": "725 American Ave",
            "city": "Waukesha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531885031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.