Individual provider Active NPI

Amanda Hallquist, NP

  • Family Nurse Practitioner
  • Brookfield, WI
National Provider Identifier
1396247789
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8252-33 Issued in WI
Practice address
21700 Intertech Dr
Brookfield, WI 53045-5197
Phone
(262) 532-8300
NPI assigned
Mar 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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 8252-33 WI Primary

Addresses

Primary practice location

21700 Intertech Dr
Brookfield, WI 53045-5197

Mailing address

4460 N 135TH St
Brookfield, WI 53005-1224
Phone (262) 370-0239

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
I20180404000674 WI Practitioner - Nurse Practitioner 9830452838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

21700 Intertech Dr
Brookfield, WI 53045-5197
Phone (262) 532-8300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Feb 17, 2018 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients

Locations

21700 Intertech Dr
Brookfield, WI 53045
Phone (262) 532-8300

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

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

Interoperability endpoints

  • Direct secure messaging: ahallquistapnp241665@direct.froedtert.com

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 1

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1396247789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 N 135TH ST",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530051224",
            "telephone_number": "262-370-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21700 INTERTECH DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455197",
            "telephone_number": "262-532-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLQUIST",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8252-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.