Individual provider Active NPI

Stephanie Ghojallu, APNP

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1356797393
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6868-33 Issued in WI
Practice address
2450 W North Ave
Milwaukee, WI 53205-1001
Phone
(414) 801-0238
NPI assigned
May 9, 2016
Last updated
May 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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 6868-33 WI Primary

Addresses

Primary practice location

2450 W North Ave
Milwaukee, WI 53205-1001

Mailing address

2450 W North Ave
Milwaukee, WI 53205-1001
Phone (414) 801-0238

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
I20160607002480 WI Practitioner - Nurse Practitioner 0446540256 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Podiatry Services CurrentSince Jun 20, 2022 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Apr 28, 2019 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
Health Connections Incorporated CurrentSince Nov 4, 2018 Accepting new patients
St Ann Center for Intergenerational Care Inc Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

4655 N Port Washington Rd
Ste 325
Milwaukee, WI 53212
Phone (414) 269-8282

803 W Layton Ave
Milwaukee, WI 53221
Phone (414) 253-8330

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1356797393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W NORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051001",
            "telephone_number": "414-801-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 W NORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051001",
            "telephone_number": "414-801-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOJALLU",
        "first_name": "STEPHANIE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6868-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.