Individual provider Active NPI

Emily Marie Weiss, RN, APNP

  • Family Nurse Practitioner
  • Mazomanie, WI
National Provider Identifier
1336428200
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4496-33 Issued in WI
Practice address
506 Crocker St Ste 3
Mazomanie, WI 53560-9426
Phone
(608) 795-4110
NPI assigned
Aug 10, 2011
Last updated
Mar 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 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 4496-33 WI Primary

Addresses

Primary practice location

506 Crocker St Ste 3
Mazomanie, WI 53560-9426

Mailing address

PO Box 160
Prairie Du Sac, WI 53578-0160
Phone (608) 643-3311

Other practice location 1

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 745-4598

Other practice location 2

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 745-4598

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address saukprairie@directclinics.saukprairiehealthcare.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
I20110830000079 WI Practitioner - Nurse Practitioner 8820268964 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sauk Prairie Healthcare IncGroup PAC ID 8224948054, 122 clinicians

Practice addresses (Care Compare)

506 Crocker St
Suite 3
Mazomanie, WI 53560-9426
Phone (608) 795-4110

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Aug 10, 2011 Accepting new patients
Sauk Prairie Healthcare, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Aug 10, 2011 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Surgical Associates CurrentSince Apr 1, 2025 Accepting new patients
Sauk Prairie Healthcare Inc Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

160 Valley Dr
Lodi, WI 53555
Phone (608) 592-3296

506 Crocker St
Ste 3
Mazomanie, WI 53560
Phone (608) 795-4110

825 Main St
Plain, WI 53577
Phone (608) 546-4211

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

250 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2431

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

436 Sunrise Dr
Spring Green, WI 53588
Phone (608) 588-2502

Interoperability endpoints

  • Direct secure messaging: emily.weiss@direct.saukprairiehealthcare.org
  • Direct secure messaging: eweiss841870@direct.unitypoint.org
  • FHIR API: https://api.platform.athenahealth.com/9971/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 9

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 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": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1336428200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535780160",
            "telephone_number": "608-643-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CROCKER ST STE 3",
            "city": "MAZOMANIE",
            "state": "WI",
            "postal_code": "535609426",
            "telephone_number": "608-795-4110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 New Pinery Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "WI",
            "postal_code": "539019240",
            "country_code": "US",
            "telephone_number": "608-745-4598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2817 New Pinery Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "WI",
            "postal_code": "539019240",
            "country_code": "US",
            "telephone_number": "608-745-4598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISS",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "credential": "RN, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "4496-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "saukprairie@directclinics.saukprairiehealthcare.org",
            "affiliation": "N",
            "address_1": "506 Crocker St Ste 3",
            "city": "Mazomanie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535609426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mazomanie, WI

Sources for this page

Verify at the official NPI Registry.