Individual provider Active NPI

Amy Sue Gumieny, NP

  • Nurse Practitioner
  • North Fond Du Lac, WI
National Provider Identifier
1386180362
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7526 Issued in WI
Practice address
700 Park Ridge LN
North Fond Du Lac, WI 54937-1385
Phone
(920) 926-7800
NPI assigned
Jan 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7526 WI Primary

Addresses

Primary practice location

700 Park Ridge LN
North Fond Du Lac, WI 54937-1385

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1411 N Taylor Dr
Sheboygan, WI 53081-3043
Phone (920) 458-4419

Other practice location 2

1111 Bayshore Dr
Manitowoc, WI 54220-5548
Phone (920) 682-6376

Other identifiers 1

IdentifierTypeStateIssuer
100064831MedicaidWI

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
I20170315002557 WI Practitioner - Nurse Practitioner 9436434354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
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)

700 Park Ridge LN
North Fond Du Lac, WI 54937-1385
Phone (920) 926-7800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Apr 6, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 6, 2024 Accepting new patients
Baycare Clinic LLP CurrentSince May 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Baycare Clinic LLP CurrentSince May 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1035 Kepler Dr
Green Bay, WI 54311

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

1111 Bayshore Dr
Manitowoc, WI 54220
Phone (920) 682-6376

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

700 Park Ridge Ln
North Fond du Lac, WI 54937
Phone (920) 907-7450

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

Interoperability endpoints

  • Direct secure messaging: agumieny368006@direct.myadvocateaurora.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1386180362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PARK RIDGE LN",
            "city": "NORTH FOND DU LAC",
            "state": "WI",
            "postal_code": "549371385",
            "telephone_number": "920-926-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 N Taylor Dr",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "530813043",
            "country_code": "US",
            "telephone_number": "920-458-4419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Bayshore Dr",
            "address_purpose": "LOCATION",
            "city": "Manitowoc",
            "state": "WI",
            "postal_code": "542205548",
            "country_code": "US",
            "telephone_number": "920-682-6376",
            "fax_number": "920-652-0115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUMIENY",
        "first_name": "AMY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100064831",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.