Susan E Selthofner, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11839 Issued in WI

Practice address

11101 W Lincoln Ave
West Allis, WI 53227-1133

Phone

(800) 767-4411

Fax

(414) 328-3708

NPI assigned

Nov 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, IA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

University of Minnesota Medical School, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psych Med Management LLCGroup PAC ID 5294053443, 3 clinicians

Watertown Physician Practices LLCGroup PAC ID 8022329408, 64 clinicians

Evizzit of Iowa Psychiatry PCGroup PAC ID 2860825924, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Psych Med Management LLC

  • Community/Behavioral Health Agency
  • Thiensville, WI
  • NPI 1376941963
  Medicare reassignment Care Compare group NPD
• Watertown Physician Practices LLC

  • Family Medicine Physician
  • Watertown, WI
  • NPI 1770964363
  Medicare reassignment Care Compare group
• Evizzit of Iowa Psychiatry PC

  • Psychiatry Physician
  • West Des Moines, IA
  • NPI 1740841188
  Medicare reassignment Care Compare group
• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Medicare reassignment NPD
• Black River Health Inc

  • Critical Access Hospital
  • Black River Falls, WI
  • NPI 1811940331
  Medicare reassignment
• Watertown Physician Practices LLC

  • Obstetrics & Gynecology Physician
  • Watertown, WI
  • NPI 1225412265
  NPD
• Watertown Physician Practices LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Watertown, WI
  • NPI 1760866891

  Psychiatric/Mental Health

  NPD
• Broadlawns Medical Center

  • Pharmacy
  • Des Moines, IA
  • NPI 1013197060
  NPD
• Evizzit of Iowa Psychiatry PC

  • Adult Mental Health Clinic/Center
  • West Des Moines, IA
  • NPI 1679233183
  NPD (past)

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1356008668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 GREEN TREE RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901755",
            "telephone_number": "702-283-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271133",
            "telephone_number": "800-767-4411",
            "fax_number": "414-328-3708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 E Kearsley St",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485021907",
            "country_code": "US",
            "telephone_number": "810-762-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELTHOFNER",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "11839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryanne Margaret Sekeres, APNP
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• Select Specialty Hospital - Milwaukee Inc
• Select Specialty Hospital - Milwaukee, Inc.
• Sandy Sell, MNT
• Senior Bridge LLC
• Serene Motherhood Services LLC
• Breana Sarah Serrano, MD
• Sara M Seruga, R.N.
• Angela Seufert, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in West Allis, WI
• Providers in West Allis, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.