Individual provider Active NPI

Talia S Hellman, FNP-BC, APNP

  • Family Nurse Practitioner
  • Mequon, WI
National Provider Identifier
1386984821
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5230-33 Issued in WI
Practice address
12800 N Lake Shore Dr
Student Health Center
Mequon, WI 53097-2418
Phone
(262) 243-4575
Fax
(262) 243-3574
NPI assigned
Feb 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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 5230-33 WI Primary

Addresses

Primary practice location

12800 N Lake Shore Dr
Student Health Center
Mequon, WI 53097-2418

Mailing address

12800 N Lake Shore Dr
Student Health Center
Mequon, WI 53097-2418
Phone (262) 243-4575

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
I20210727003051 WI Practitioner - Nurse Practitioner 3476955907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mequon Clinical Associates SCGroup PAC ID 5092876524, 11 clinicians

Practice addresses (Care Compare)

1045 W Glen Oaks LN
Mequon, WI 53092-3477
Phone (262) 241-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5230-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mequon Clinical Associates, SC CurrentSince Jun 1, 2021 Accepting new patients

Locations

1045 W Glen Oaks Ln
Ste 1
Mequon, WI 53092
Phone (262) 241-7778

Organizations & group practices 1

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": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1386984821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 N LAKE SHORE DR",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972418",
            "telephone_number": "262-243-4575",
            "fax_number": "262-243-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 N LAKE SHORE DR",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972418",
            "telephone_number": "262-243-4575",
            "fax_number": "262-243-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLMAN",
        "first_name": "TALIA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5230-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.