NPIMap

Individual provider Active NPI

Kristen M Jerabek, APNP

  • Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1316239254
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4367-33 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(920) 288-8000
NPI assigned
May 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4367033 WI
Nurse Practitioner 363L00000X 4367-33 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

PO Box 735041
Chicago, IL 60673-5041
Phone (920) 288-8000

Other identifiers 1

IdentifierTypeStateIssuer
100019477MedicaidWI

Other names 1

  • Kristen M Moen Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmoen187259@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120316000410 WI Practitioner - Nurse Practitioner 9234398850 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians
Aspirus Stevens Point Hospital and Clinics, Inc.Group PAC ID 1850358938, 136 clinicians

Practice addresses (Care Compare)

425 Pine Ridge Blvd
Wausau, WI 54401-4123
Phone (715) 843-1067

900 Illinois Ave
Stevens Point, WI 54481-3114
Phone (715) 346-5000

Hospital & facility affiliations

  • Aspirus Riverview Hospital & Clinics Inc Hospital, Wisconsin Rapids, WI, CCN 520033
  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4367-33WIMDNurse Practitioner
4367033WIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Oct 10, 2025 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Feb 7, 2025 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Feb 7, 2025 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Oct 10, 2025 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

209 Prentice St N
Stevens Point, WI 54481
Phone (715) 344-4611

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

190 Grand Seasons Dr
Waupaca, WI 54981
Phone (715) 258-3401

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

425 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2400

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Interoperability endpoints

  • Direct secure messaging: kmoen187259@direct.myadvocateaurora.org

Organizations & group practices 10

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 12

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": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1316239254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735041",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735041",
            "telephone_number": "920-288-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERABEK",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "4367033",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4367-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100019477",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmoen187259@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "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": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "MOEN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.