Individual provider Active NPI

Constance Lynn Cayer-Wirtz, N.P.

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1396036901
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4361-033 Issued in WI
Practice address
11200 W Parkland Ave
Milwaukee, WI 53224-3127
Phone
(888) 562-5442
Fax
(562) 499-6171
NPI assigned
Apr 29, 2011
Last updated
Apr 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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 4361-033 WI Primary
Adult Health Nurse Practitioner 363LA2200X 4361-033 WI

Addresses

Primary practice location

11200 W Parkland Ave
Milwaukee, WI 53224-3127

Mailing address

200 Ocenagate
Suite 100
Long Beach, CA 90802-4317
Phone (562) 499-6199

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
I20110721000736 WI Practitioner - Nurse Practitioner 6608044490 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4361-033WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Wisconsin Inc CurrentSince Nov 5, 2024 Accepting new patients
Molina Care Connections, LLC. Nurse Practitioner PastSince Mar 26, 2018 Accepting new patients

Locations

5750 Johnston St
Ste 205
Lafayette, LA 70503
Phone (337) 580-3330

1366 E Sumner St
Hartford, WI 53027
Phone (337) 408-0805

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, 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": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1396036901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCENAGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6199",
            "fax_number": "562-499-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 W PARKLAND AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243127",
            "telephone_number": "888-562-5442",
            "fax_number": "562-499-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAYER-WIRTZ",
        "first_name": "CONSTANCE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-29",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4361-033",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "4361-033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.