Individual provider Active NPI

Emily A Staszak, NP

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1366878100
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5500 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy
Ste 165
Milwaukee, WI 53215
Phone
(414) 385-2301
NPI assigned
Sep 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5500 WI Primary
Family Nurse Practitioner 363LF0000X 5500 WI

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy
Ste 165
Milwaukee, WI 53215

Mailing address

2901 W Kinnickinnic River Pkwy Ste 305
Milwaukee, WI 53215-3660
Phone (414) 385-5999

Other practice location 1

2801 W Kinnickinnic River Pkwy
Ste 165
Milwaukee, WI 53215-3669
Phone (414) 385-2301

Other identifiers 1

IdentifierTypeStateIssuer
100032965MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address estaszak29066@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: 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
I20131118001722 WI Practitioner - Nurse Practitioner 1254567472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3677
Phone (414) 649-3990

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5500WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 20, 2013 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 20, 2013 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

2801 W Kinnickinnic River Pkwy
Ste 165
Milwaukee, WI 53215
Phone (414) 385-2301

2901 W Kinnickinnic River Pkwy
Ste 507
Milwaukee, WI 53215
Phone (414) 649-3480

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2901 W Kinnickinnic River Pkwy
Ste 305
Milwaukee, WI 53215
Phone (414) 645-6070

Interoperability endpoints

  • Direct secure messaging: estaszak29066@direct.myadvocateaurora.org

Organizations & group practices 3

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 2

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": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1366878100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 305",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-385-5999",
            "fax_number": "414-385-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "STE 165",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-385-2301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "Ste 165",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153669",
            "country_code": "US",
            "telephone_number": "414-385-2301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STASZAK",
        "first_name": "EMILY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5500",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100032965",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "estaszak29066@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "Ste 165",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "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": "2801 W Kinnickinnic River Pkwy",
            "address_2": "Ste 165",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.